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Hum. Reprod. Advance Access published online on August 27, 2004
Human Reproduction, doi:10.1093/humrep/deh397
© 2004 by European Society of Human Reproduction and Embryology
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Received December 8, 2003
Revised January 22, 2004
Accepted June 7, 2004

Article

Cervical priming prior to operative hysteroscopy: a randomized comparison of laminaria versus misoprostol

A.M. Darwish 1*, A.M. Ahmad 1, A.M. Mohammad 1

1 Department of Obstetrics and Gynecology, Assiut University Hospital, Assiut, Egypt

* To whom correspondence should be addressed. E-mail: a_darwish{at}mailcity.com.


  Abstract

BACKGROUND: We aimed to compare efficacy of intravaginal misoprostol versus endocervical laminaria tents prior to operative hysteroscopy in selected cases. METHODS: A total of 144 patients with diagnosed intrauterine lesions scheduled for operative hysteroscopy were randomly allocated to two groups according to method of cervical priming prior to the procedure. Misoprostol 200 µg was inserted into the posterior fornix of the vagina for patients in group A (n=72), while laminaria tents were inserted intracervically in group B patients (n=72). RESULTS: Both methods were effective for cervical dilatation with a mean cervical diameter of 7.5±1.2 and 7.6±1.2 mm respectively. There was no significant difference in the mean cervical diameter or the time required for cervical dilatation (51.6 versus 51.4 s respectively). In contrast, there was a significant difference between the groups with respect to the insertion difficulty and in doctors' and patients' assessments of the procedure. CONCLUSIONS: Both misoprostol and laminaria were equally effective in inducing proper cervical priming prior to operative hysteroscopy with minimal time of cervical dilatation. Nevertheless, misoprostol may be superior due to easy application, reduced cost, and patient convenience and acceptability.

Keywords: hysteroscopy; laminaria; misoprostol.
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