Ideal Time of Vaginal Misoprostol Administration in nulliparous women undergoing Office Hysteroscopy: a randomized double blind placebo controlled study

Abstract

Background: hysteroscopy is the process of viewing and operating in the endometrial cavity from a transcervical approach. It is the gold standard procedure for uterine cavity exploration. Objective: to detect ideal time of vaginal misoprostol administration for cervical priming in nulliparous women prior to office hysteroscopy by comparing between giving 400 microgram 3 hours, 6 hours and 12 hours before office hysteroscopy. Patients and Methods: randomized double-blind placebo-controlled study. This study was done on 198 patients to whom office hysteroscopy was done as a part of investigation of (infertility,recurrent miscarriage or abnormal uterine bleeding). Result: in group A which received 400μgm vaginal misoprostol 12 hours before office hysteroscopy, pain score was lower compared to group B compared to group C . Procedural time was shorter in group A compared to group B compared to group C , cervical entry was easier in group A compared to group B compared to group C , baseline cervical dilatation was greater in group A compared to group B compared to group C vaginal bleeding was least in group A compared to group B compared to group C . Conclusion: use of 400μgm vaginal misoprostol 12 hours before hysteroscopy is better than using it 6 hours and 3 hours in facilitating cervical ripening with minimal side effects without use of anasthesia.as it decrease pain score, decrease procedure duration, increase ease of cervical entry, higher patient acceptability and with minimal side effects