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Title: Randomized trial to determine optimal dose of vaginal misoprostol for preabortion cervical priming
Authors: Singh, K. 
Fong, Y.F.
Prasad, R.N.V. 
Dong, F. 
Issue Date: 1998
Citation: Singh, K., Fong, Y.F., Prasad, R.N.V., Dong, F. (1998). Randomized trial to determine optimal dose of vaginal misoprostol for preabortion cervical priming. Obstetrics and Gynecology 92 (5) : 795-798. ScholarBank@NUS Repository.
Abstract: Objective: To determine the optimal dosage of vaginal misoprostol for cervical priming before vacuum aspiration abortion. Methods: One hundred twenty women were assigned randomly to receive 200, 400, 600, or 800 μg of misoprostol given vaginally. Vacuum aspiration was performed 3-4 hours after the insertion of misoprostol tablets. The degree of cervical dilation before operation was measured with a Hegar dilator. Preoperative and intraoperative blood loss and associated side effects also were assessed. Results: Twenty- nine (96.7%) women in the 400-μg group and all in the 600-μg and 800-μg groups achieved cervical dilation of at least 8 mm. The success rate for the 200-μg group was only 23.3%, significantly less efficacious than the 400- μg dose (odds ratio 95.3; 95% confidence interval 10.9, 830.9; P < .001). There was no significant difference among the 400-, 600-, and 800-μg groups (P = .364) with respect to achieving cervical dilation at least 8 mm. However, 800 μg was associated with significantly more side effects than 600 μg (preoperative and intraoperative blood loss, P < .001; abdominal pain, P = .005; products of conception at os, P < .001; fever higher than 38.0C, P = .002). When 400 μg and 600 μg were compared, we found that the higher dose also was associated with significantly more side effects. The 600-μg group was used twice in the comparison, but all P values remained significant even after the Bonferroni adjustment for multiple comparisons. Conclusion: Vaginal application of 400 μg of misoprostol is the optimal dose for vacuum aspiration preabortion cervical dilation in first-trimester nulliparas.
Source Title: Obstetrics and Gynecology
ISSN: 00297844
DOI: 10.1016/S0029-7844(98)00281-6
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