A prospective randomized control trial comparing vaginal misoprostol againts gemeprost as cervical priming agent in pre-surgical evaluation of missed abortion
| dc.contributor.author | Md Noor, Mansor | |
| dc.date.accessioned | 2017-08-17T06:43:13Z | |
| dc.date.available | 2017-08-17T06:43:13Z | |
| dc.date.issued | 2001 | |
| dc.description.abstract | OBJECTIVE: To cotnpare the effectiveness, side effect and cost effectiveness of vaginal misoprostol against the standard drug, gemeprost, as cervical priming agent in pre-surgical evacuation in first and early second trimester missed abortion. DESIGN: A prospective randomised controlled study. SETTING: Gynaecology ward, Hospital University Sains Malaysia, Kubang Kerian, Kelantan, from the 1st. of December 1999 till 30th. of June 2000. METHODS: Women who fulfilled the inclusion and exclusion criteria were randomly allocated to either receive 400-microgram misoprostol or 1- milligram gemeprost vaginally for at least 2 hours before surgical evacuation of missed abortion. The degree of the cervical dilatation was measured using 1-legar's dilator. The easiness of the evacuation procedure, intra-operative blood loss and associated side effect were also assessed. The inclusion criteria's include confinned missed abortion by ultrasound, period of gestation up to early second trimesters, cervical length more than 1 cm cervical Os less than 0.5 em and patient consented to be included in the study. While the exclusion criteria were uterine size of 14 weeks or more on abdominal palpation, patient known to have had history of allergic reaction to any prostaglandin products, severe tnedical disease, abnom1al coagulation profile and patient refusal to be included in this study. RESULTS: Both n1isoprostrol and gemeprost used has satisfactory cervical ripening effect, although there was no significant difference in the dilatation ability between them ( p = 0.912 ). The tnean Hegar's dilator for misoprostol and getneprost were 10.05 ( SD 4.43 ) and I 0.20 (SD = 4.11 ) respectively. The comtnonest side effects were per-vaginal bleeding ( 50% for tnisoprosto1 and 55% for getneprost ) and abdominal pain ( 45% vs.30% ), occurred with almost similar frequency in the misoprostol and gemeprost group, while the other side effects ( headache, nausea and febrile episode ) of both drugs were minimal and negligible. There was no side effect ofvotniting, shivering or diarrhoea in any of our patients. CONCLUSION: Vaginally applied misoprostol was as effective as gemeprost in cervical priming prior to surgical evacuation of miissed abortion. The mean Hegar's dilator were 10.05 for misoprostol and 10.20 for gemeprost. The occurrences of side effect in both drugs were minor, small in numbers and were similar in nature. Misoprostol (RM02.00) was moore cost effective than gemeprost (RM98.00) in cervical priming prior to surgical evacuation of missed abortion in first and early second trimesters. | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/4376 | |
| dc.language.iso | en | en_US |
| dc.publisher | Universiti Sains Malaysia | en_US |
| dc.subject | Vaginal misoprostol | en_US |
| dc.title | A prospective randomized control trial comparing vaginal misoprostol againts gemeprost as cervical priming agent in pre-surgical evaluation of missed abortion | en_US |
| dc.type | Thesis | en_US |
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