Use of cervical dilators is not necessary during curettage after combined oral and vaginal administration of misoprostol from five to ten weeks of pregnancy

Abstract

Abstract Aim. The aim of this study was to determine the efficacy of oral and vaginal misoprostol administered for cervical priming in nullipar women before first-trimester surgical abortion. Methods. Medical records of 84 nulliparous women, aged 18-42 years, who admitted for pregnancy termination request were reviewed retrospectively. The pregnancies were between 5 and 10 weeks of gestation. 100 µg misoprostol was administered by oral and vaginal route in 84 patients. The doses repeated 4 hours later. Exclusion criteria were systemic disease, a history of cervical operations, bleeding or spotting during the current pregnancy and basal cervical dilation greater than 4mm. Results. Targeted cervical dilatation for pregnancy termination was determined according to gestational age of every patient (for gestations at 5, 6, 7, 8, 9, and 10 weeks, required cervical dilatations from 5, 6, 7, 8, 9, and 10 mm, respectively). A significant correlation was found between gestational ages and achieved cervical dilatation after misoprostol use. Conclusions. Suggested administration of misoprostol provides adequate cervical dilatation. Use of cervical dilators is not necessary during curettage after administration 100 µg misoprostol oral and vaginal two times four hours apart from five to ten weeks of pregnancy. Key words: Misoprostol; first trimester abortion; cervical priming Ozet Amac. Bu calismanin amaci birinci trimester cerrahi abortus oncesi nullipar kadinlara servikal olgunlasma icin uygulanan oral ve vajinal misoprostolun etkinliginin belirlenmesidir. Yontem. Gebelik sonlandirmasi istemiyle basvuran, 18-42 yas arasi toplam 84 nullipar kadinin medikal kayitlari geriye donuk olarak degerlendirilmistir. Gebelikler 5-10. gebelik hafalari arasinda idi. 84 hastaya oral ve vajinal yolla 100 µg misoprostol uygulanmistir. Dozlar 4 saat sonra tekrarlanmistir. Dislama kriterleri sistemik hastalik, servikal operasyon hikayesi, mevcut gebelik suresince kanama veya lekelenme ve bazal servikal dilatasyon duzeyinin 4 mm’den fazla olmasiydi. Bulgular. Her hastada gebelik terminasyonu icin hedeflenen servikal dilatasyon gestasyonel yasa gore belirlenmistir (5, 6, 7, 8, 9 ve 10 haftalik gebelikler icin gerekli gorulen servikal dilatasyon sirasiyla 5, 6, 7, 8, 9 ve 10 mm). Sonuclar. Misoprostolun onerilen uygulama sekli yeterli servikal dilatasyon saglar. Bes ile on hafta arasindaki gebeliklerde dort saat ara ile iki kez oral ve vajinal 100 µg misoprostol uygulamasindan sonra kuretaj esnasinda servikal bujiye gerek kalmamaktadir. Anahtar sozcukler: Misoprostol, ilk trimester abortus, servikal olgunlasma