Role of Misoprostol in Cervical Ripening for Dilatation and Curettage

ABSTRACT

Background: Difficulty in cervical dilatation is a hard situation during the procedure of diagnostic dilatation and curettage in some cases. Aim: Aim of the present study was to evaluate the use of Misoprostol for cervical dilatation before D&C in Gynecological cases. Dilatation of cervix is performed as a preliminary step to curette the uterine cavity. Endometrial sampling is often performed either by D&C or by hysteroscopy as an office procedure. Materials and methods: The study was performed at Department of Obstetrics and Gynecology, Victoria Hospital, Visakhapatanam, Andhra Pradesh from June 2018 to May 2019. The study comprised of 150 patients recruited from Gynecology Department with different indications for D&C. Selected cases had a full history of menstrual, Gynec, Obstetric, Personal and Family. A per abdomen and per speculum examination were done to note the Vaginal and Cervical condition. A bimanual pelvic examination was done to estimate size, position and mobility of uterus. In this study, the patients were allocated to receive either oral or vaginal misoprostol or no drug. All the subjects allocated to receive either oral or vaginal Misoprostol were instructed to take the medication at home, the night before the operative procedure. They were given 200 micro grams Misoprostol orally or vaginally 12 hours prior to the procedure. Results: In present study, majority of cases (57.33%) fall in age group of 30-39 years and 34% cases fall in age group of 40-49 years. 83% in Misoprostol group and 90% cases in control group had previous vaginal deliveries. 19% cases in Misoprostol and 20% cases in control group had a prior uterine surgery. Indication for D&C, in majority of cases 66 cases (44%) Heavy menstural bleeding was an indication, followed by Irregular bleeding 53 cases (35.33%), Intermenstural bleeding 29 cases R. Padmaja, P. Rajasekhar. Role of Misoprostol in Cervical Ripening for Dilatation and Curettage. IAIM, 2019; 6(11) 118- 123. Page 119 (19.33%). Cervical dilatation effectively achieved in 62.5% in Nulliparous 69.2% in Primiparous, 94.93% in Multiparous. Conclusion: Both Oral and Vaginal Misoprostol are equally effective in inducing Cervical priming prior to Dilatation and Curettage.