A systematic review and meta-analysis of randomized studies comparing misoprostol versus placebo for cervical ripening prior to hysteroscopy
Φόρτωση...
Ημερομηνία
Συγγραφείς
Gkrozou, F.
Koliopoulos, G.
Vrekoussis, T.
Valasoulis, G.
Lavasidis, L.
Navrozoglou, I.
Paschopoulos, M.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Eur J Obstet Gynecol Reprod Biol
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVE(S): Hysteroscopy is an effective method for examining the uterine cavity but has some limitations, including the occasional need for cervical dilatation. Misoprostol is routinely used for cervical dilatation in various procedures but has not gained wide acceptance for use before hysteroscopy. STUDY DESIGN: This review includes randomized controlled trials which compare the use of misoprostol versus placebo by different routes and doses before diagnostic or operative hysteroscopy. The MEDLINE database and the Cochrane Central Register of Controlled Trials were searched for articles published from January 1970 to April 2010. The outcome measures studied were related either to the facilitation of the hysteroscopic procedure (need for cervical dilatation, cervical width at the beginning of hysteroscopy, duration of the procedure and complications such as cervical tear and uterine perforation) or to the medication side-effects. With regard to side-effects, we studied the incidence of nausea, diarrhea, abdominal pain, bleeding, and fever. RESULTS: Vaginal misoprostol reduced the need for cervical dilatation in the total population of pre- and post-menopausal women to a statistically significant degree. In the subgroup of operative hysteroscopy the need for dilatation and the duration of the procedure were also significantly reduced. Most other outcomes relating to the facilitation of the procedure did not reach statistical significance. The side effects in the misoprostol group were significantly more frequent than in the placebo group. CONCLUSION(S): There is insufficient evidence to recommend the routine use of misoprostol before every hysteroscopy. As the lack of serious benefit from misoprostol is unlikely to be due to type II error, its use should be reserved for selected cases.
Περιγραφή
Λέξεις-κλειδιά
Cervix Uteri/*drug effects, Female, Humans, *Hysteroscopy, Misoprostol/*administration & dosage/adverse effects, Oxytocics/*administration & dosage/adverse effects, Publication Bias, Randomized Controlled Trials as Topic, Treatment Outcome
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/21621897
http://ac.els-cdn.com/S0301211511002387/1-s2.0-S0301211511002387-main.pdf?_tid=044688d3305d02e474e9508cb38a1827&acdnat=1333540548_b5f3ba98d61d8c1f87e533884080ebd4
http://ac.els-cdn.com/S0301211511002387/1-s2.0-S0301211511002387-main.pdf?_tid=044688d3305d02e474e9508cb38a1827&acdnat=1333540548_b5f3ba98d61d8c1f87e533884080ebd4
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής