A double-blind randomized controlled trial of two different doses of misoprostol for cervical priming prior to office hysteroscopy

Objective To evaluate and compare the effectiveness of 200 μg vaginal misoprostol vs. 400 μg vaginal misoprostol administrated 3 h prior to office hysteroscopy, in cervical priming. Design: Randomized controlled trial. Setting Outpatient clinic of the Cairo University Hospital, Cairo, Egypt. Materials and methods One hundred and thirty-two women scheduled for office hysteroscopy; were randomized into two groups. Patients were divided into two groups: group I; 66 patients received 200 μg vaginal misoprostol and group II; 66 patients received 400 μg vaginal misoprostol. Primary outcome was pain score (visual analogue scale). Major outcome measures 400 μg vaginal misoprostol significantly minimized pain score and procedure time, a significant increase in the ease of entry and the patient acceptability was observed in the 400 μg vaginal misoprostol group. Side effects of misoprostol were minor and transient with no statistically significant difference between both groups. Major conclusions 400 μg vaginal misoprostol 3 h prior to office hysteroscopy appears to be more effective than 200 μg vaginal misoprostol in facilitating cervical ripening, minimizing pain score and procedure time, without any increase in side effect occurrence.