Prospective study of laminaria, vaginal misoprostol, and mechanical dilator applications before surgical intervention in first-trimester pregnant women with missed abortion

Conclusion: Laminaria provides cervical preparedness similar to intracervical misoprostol without increasing the side effects in the management of first-trimester pregnant women with missed abortion.

📌 3 Maddede Bu Makale

🎯

Amaç & Hipotez:Objective: We aimed to compare the efficacies of laminaria, vaginal misoprostol, and mechanical dilator applications before surgical intervention with regard to the optimal cervical dilation and severity of pain in first-trimester pregnant women with missed abortion.

📊

Temel Bulgular & Veri:Materials and Methods: The prospective study included a total of 103 patients with a diagnosis of missed abortion in the sixth-tenth gestational week randomly divided into 3 groups of 400 µg vaginal misoprostol, luminaria, or mechanical dilator applications for the dilation of the cervix before surgical intervention.

💡

Sonuç & Katkı:Conclusion: Laminaria provides cervical preparedness similar to intracervical misoprostol without increasing the side effects in the management of first-trimester pregnant women with missed abortion.

🔬Tür:Araştırma Makalesi

📍Kapsam:Genişletilmiş Akademik Örneklem

⚙️Değişkenler:Alan Parametreleri

Özet

Objective: We aimed to compare the efficacies of laminaria, vaginal misoprostol, and mechanical dilator applications before surgical intervention with regard to the optimal cervical dilation and severity of pain in first-trimester pregnant women with missed abortion. Materials and Methods: The prospective study included a total of 103 patients with a diagnosis of missed abortion in the sixth-tenth gestational week randomly divided into 3 groups of 400 µg vaginal misoprostol, luminaria, or mechanical dilator applications for the dilation of the cervix before surgical intervention. The effects of laminaria and vaginal misoprostol on the cervical ripening for surgical intervention were evaluated using the Hegar test. Visual analog scale (VAS) values were evaluated during the first application, throughout the period of their applications, and after the surgical intervention. Results: The cervical dilation was found to be similar in the laminaria and vaginal application groups (p=0.64). During the first application, laminaria caused more pain than misoprostol but the difference was not statistically significant (p=0.28). Throughout the period of application and after the surgical intervention, although there was less pain with respect to VAS values after laminaria application, this was not statistically significant (p=0.11). The VAS values after the surgical intervention was determined to be statistically higher after mechanical dilatation compared to other procedures (p=0.001). Conclusion: Laminaria provides cervical preparedness similar to intracervical misoprostol without increasing the side effects in the management of first-trimester pregnant women with missed abortion.

🔖

Bu Makaleye Atıf Yap

KARAKUŞ, S., GENÇ, Ş. Ö., ULUDAĞ, S., OKŞAŞOĞLU, B., SÖNMEZ, G., YILDIZ, Ç., ÇETİN, A. (2018). Prospective study of laminaria, vaginal misoprostol, and mechanical dilator applications before surgical intervention in first-trimester pregnant women with missed abortion. Erciyes Medical Journal, Cilt: 40 - Sayı: 1, 13–17. https://ajindex.com/articles/190522

📄 Tam Metin PDF Okuyucu

Yeni Sekmede Aç ↗

↗Yeni Sekme

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (2)

McNamee K, Dawood F, Farquharson RG. Thrombophilia and early pregnancy loss. Best Pract Res Clin Obstet Gynaecol 2012; 26(1): 91-102. [CrossRef] American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 427: misoprostol for postabortion care. Obstet Gynecol 2009; 113: 465-8. [CrossRef] Pandya PP, Snijders RJ, Psara N, Hilbert L, Nicolaides KH. The prevalence of non-viable pregnancy at 10-13 weeks of gestation. Ultrasound Obstet Gynecol 1996; 7(3): 170-3. [CrossRef] Cunningham, F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. USA: McGraw-Hill; 2013. Black KI, de Vries BS, Moses F, Pelosi M, Cong A, Ludlow J. The impact of introducing medical management on conservative and surgical management for early pregnancy miscarriage. Aust N Z J Obstet Gynaecol 2017; 57(1): 93-8. [CrossRef] Inal HA, Ozturk Inal ZH, Tonguc E, Var T. Comparison of vaginal misoprostol and dinoprostone for cervical ripening before diagnostic hysteroscopy in nulliparous women. Fertil Steril 2015; 103(5): 1326-31. [CrossRef] Creinin MD. Mifepristone vs. osmotic dilator insertion for cervical preparation prior to surgical abortion at 14-16 weeks: a randomized trial. Contraception 2013; 87(4): 507-8. [CrossRef] Firouzabadi RD, Sekhavat L, Tabatabaii A, Hamadani S. Laminaria tent versus Misoprostol for cervical ripening before surgical process in missed abortion. Arch Gynecol Obstet 2012; 285(3): 699-703. [CrossRef] Karakus S, Akkar OB, Yildiz C, Yenicesu GI, Cetin M, Cetin A. Comparison of Effectiveness of Laminaria versus Vaginal Misoprostol for Cervical Preparation Before Operative Hysteroscopy in Women of Reproductive Age: A Prospective Randomized Trial. J Minim Invasive Gynecol 2016; 23(1): 46-52. [CrossRef] Turner JV, Agatonovic-Kustrn S, Ward H. Off-label use of misoprostol in gynaecology. Facts Views Vis Obgyn 2015; 7(4): 261-4.
Kapp N, Lohr PA, Ngo TD, Hayes JL. Cervical preparation for first trimester surgical abortion. Cochrane Database Syst Rev 2010; 2: CD007207. [CrossRef] Allen RH, Goldberg AB; Board of Society of Family Planning. Cervical dilation before first-trimester surgical abortion ( Clouqueur E, Coulon C, Vaast P, Chauvet A, Deruelle P, Subtil D,et al. [Use of misoprostol for induction of labor in case of fetal death or termination of pregnancy during second or third trimester of pregnancy: Efficiency, dosage, route of administration, side effects, use in case of uterine scar]. J Gynecol Obstet Biol Reprod (Paris).