| Isosorbide mononitrate vaginal gel versus misoprostol vaginal gel versus Dilapan-S for cervical ripening before first trimester curettage. | |
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MedLine Citation:
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PMID: 17980952 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the efficacy and safety of vaginal applications of three different principles of cervical priming prior to first trimester curettage, isosorbide mononitrate (ISMN), misoprostol and Dilapan-S, a hygroscopical cervical dilator. STUDY DESIGN: Pregnant women with missed abortion between 6 and 12 gestational weeks were included and randomly assigned to receive either 80 mg ISMN vaginal gel (group 1) or 200 microg of misoprostol vaginal gel (group 2) or Dilapan-S, a hygroscopical cervical dilator (group 3), for cervical ripening before curettage. Outcome parameters were cervical dilation at the time of operation and maximum dilation reached with Hegar's dilator and the degree of difficulty in mechanical dilation as well as safety and side effects of the preparations. RESULTS: Sixty-five pregnant women with missed abortion were included and assigned to the three study groups (n=22 for group 1, n=22 for group 2, n=21 for group 3). Misoprostol vaginal gel and Dilapan-S were significantly more effective than ISMN vaginal gel in cervical dilation reached with priming (p<0.005 and p<0.005) and in the degree of difficulty in cervical dilation assessed by the surgeon (p<0.001 and p<0.01). Mild discomfort was indicated by all patients after Dilapan insertion, whereas no patient complained about discomfort after misoprostol or ISMN insertion (p<0001). Three patients suffered from mild hypotension and headache after ISMN treatment, and two had increased vaginal bleeding due to uterine atony during surgery (p<0.05). CONCLUSION: A vaginal gel of ISMN is less effective for cervical ripening prior to first trimester curettage compared to misoprostol vaginal gel or Dilapan-S. The latter could be an effective and safe alternative to prostaglandin priming avoiding preoperative contractions caused by prostaglandin preparations. |
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Authors:
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Frank Chih-Kang Chen; Anna Bergann; Jana Krosse; Andrea Merholz; Matthias David |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial Date: 2007-11-05 |
Journal Detail:
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Title: European journal of obstetrics, gynecology, and reproductive biology Volume: 138 ISSN: 0301-2115 ISO Abbreviation: Eur. J. Obstet. Gynecol. Reprod. Biol. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-02 Completed Date: 2008-10-14 Revised Date: 2008-11-29 |
Medline Journal Info:
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Nlm Unique ID: 0375672 Medline TA: Eur J Obstet Gynecol Reprod Biol Country: Ireland |
Other Details:
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Languages: eng Pagination: 176-9 Citation Subset: IM |
Affiliation:
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Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum, Klinik für Geburtsmedizin, Augustenburger Platz 1, Berlin, Germany. frank.chen@charite.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abortion, Missed
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therapy* Adolescent Adult Cervical Ripening / drug effects* Dilatation and Curettage* Female Humans Isosorbide Dinitrate / administration & dosage, analogs & derivatives* Misoprostol / administration & dosage* Oxytocics / administration & dosage* Polymers / administration & dosage* Pregnancy Pregnancy Trimester, First Vaginal Creams, Foams, and Jellies |
| Chemical | |
Reg. No./Substance:
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0/Oxytocics; 0/Polymers; 0/Vaginal Creams, Foams, and Jellies; 123535-69-3/dilapan; 16051-77-7/isosorbide-5-mononitrate; 59122-46-2/Misoprostol; 87-33-2/Isosorbide Dinitrate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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