The Journal of Minimally Invasive Gynecology
Volume 17, Issue 4 , Pages 449-455 , July 2010

Clinical Use of Misoprostol in Nonpregnant Women: Review Article

  • Chainarong Choksuchat, MD

      Affiliations

    • Corresponding Author InformationCorresponding author: Chainarong Choksuchat, MD, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkhla University, Hat-Yai, Songkhla 90110, Thailand.

Received 30 December 2009 ,Accepted 12 March 2010.

References 

  1. Garris RE, Kirkwood CF. Misoprostol: a prostaglandin E1 analogue. Clin Pharm. 1989;8:627–644
  2. Hunt JN, Smith JL, Jiang CL, Kessler L. Effect of synthetic prostaglandin E1 analog on aspirin-induced gastric bleeding and secretion. Dig Dis Sci. 1983;28:897–902
  3. Goldberg AB, Carusi DA, Meckstroth KR. Misoprostol in gynecology. Curr Womens Health Rep. 2003;3:475–483
  4. Schaff EA, Fielding SL, Westhoff C, et al. Vaginal misoprostol administered 1, 2, or 3 days after mifepristone for early medical abortion: a randomized trial. JAMA. 2000;284:1948–1953
  5. Singh K, Fong YF, Prasad RN, Dong F. Randomized trial to determine optimal dose of vaginal misoprostol for preabortion cervical priming. Obstet Gynecol. 1998;92:795–798
  6. Jain JK, Kuo J, Mishell DR. A comparison of two dosing regimens of intravaginal misoprostol for second-trimester pregnancy termination. Obstet Gynecol. 1999;93:571–575
  7. Stitely ML, Satin AJ. Cervical ripening agents and uterine stimulants. Clin Obstet Gynecol. 2002;45:114–124
  8. Morey SS. ACOG develops guidelines for induction of labor. Am Fam Physician. 2000;62:445
  9. Hofmeyr GJ, Walraven G, Gulmezoglu AM, Maholwana B, Alfirevic Z, Villar J. Misoprostol to treat postpartum haemorrhage: a systematic review. BJOG. 2005;112:547–553
  10. Crane JM, Healey S. Use of misoprostol before hysteroscopy: a systematic review. J Obstet Gynaecol Can. 2006;28:373–379
  11. Choksuchat C, Cheewadhanaraks S, Getpook C, Wootipoom V, Dhanavoravibul K. Misoprostol for cervical ripening in non-pregnant women: a randomized double-blind controlled trial of oral versus vaginal regimens. Hum Reprod. 2006;21:2167–2170
  12. Preutthipan S, Herabutya Y. A randomized controlled trial of vaginal misoprostol for cervical priming before hysteroscopy. Obstet Gynecol. 1999;94:427–430
  13. Preutthipan S, Herabutya Y. Vaginal misoprostol for cervical priming before operative hysteroscopy: a randomized controlled trial. Obstet Gynecol. 2000;96:890–894
  14. Perrone JF, Caldito G, Mailhes JB, Tucker AN, Ford WR, London SN. Oral misoprostol before office endometrial biopsy. Obstet Gynecol. 2002;99:439–444
  15. Celik H, Sapmaz E. Use of a single preoperative dose of misoprostol is efficacious for patients who undergo abdominal myomectomy. Fertil Steril. 2003;79:1207–1210
  16. Brown SE, Toner JP, Schnorr JA, et al. Vaginal misoprostol enhances intrauterine insemination. Hum Reprod. 2001;16:96–101
  17. Schoenhard G, Oppermann J, Kohn FE. Metabolism and pharmacokinetic studies of misoprostol. Dig Dis Sci. 1985;30(11 suppl):126S–128S
  18. Zieman M, Fong SK, Benowitz NL, Banskter D, Darney PD. Absorption kinetics of misoprostol with oral or vaginal administration. Obstet Gynecol. 1997;90:88–92
  19. Tang OS, Schweer H, Seyberth HW, Lee SW, Ho PC. Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod. 2002;17:332–336
  20. Khan RU, el-Refaey H, Sharma S, Sooranna D, Stafford M. Oral, rectal, and vaginal pharmacokinetics of misoprostol. Obstet Gynecol. 2004;103(5, pt 1):866–870
  21. Danielsson KG, Marions L, Rodriguez A, Spur BW, Wong PY, Bygdeman M. Comparison between oral and vaginal administration of misoprostol on uterine contractility. Obstet Gynecol. 1999;93:275–280
  22. Fong YF, Singh K, Prasad RN. A comparative study using two dose regimens (200 μ or 400 μg) of vaginal misoprostol for pre-operative cervical dilatation in first trimester nulliparae. Br J Obstet Gynaecol. 1998;105:413–417
  23. Singh K, Fong YF, Prasad RN, Dong F. Does an acidic medium enhance the efficacy of vaginal misoprostol for pre-abortion cervical priming?. Hum Reprod. 1999;14:1635–1637
  24. Uldbjerg N, Ekman G, Malmstrom A, Olsson K, Ulmsten U. Ripening of the human uterine cervix related to changes in collagen, glycosaminoglycans, and collagenolytic activity. Am J Obstet Gynecol. 1983;147:662–666
  25. el-Refaey H, Calder L, Wheatley DN, Templeton A. Cervical priming with prostaglandin E1 analogues, misoprostol and gemeprost. Lancet. 1994;343:1207–1209
  26. Rajabi MR, Solomon S, Poole AR. Biochemical evidence of collagenase-mediated collagenolysis as a mechanism of cervical dilatation at parturition in the guinea pig. Biol Reprod. 1991;45:764–772
  27. Murota S, Abe M, Otsuka K. Stimulatory effect of prostaglandins on the production of hexosamine-containing substances by cultured fibroblasts (3) induction of hyaluronic acid synthetase by prostaglandin F2alpha. Prostaglandins. 1977;14:983–991
  28. Arias F. Pharmacology of oxytocin and prostaglandins. Clin Obstet Gynecol. 2000;43:455–468
  29. Chwalisz K, Garfield RE. Nitric oxide as the final metabolic mediator of cervical ripening. Hum Reprod. 1998;13:245–248
  30. Salvemini D, Misko TP, Masferrer JL, Seibert K, Currie MG, Needleman P. Nitric oxide activates cyclooxygenase enzymes. Proc Natl Acad Sci U S A. 1993;90:7240–7244
  31. Vaisanen-Tommiska M, Mikkola TS, Ylikorkala O. Misoprostol induces cervical nitric oxide release in pregnant, but not in nonpregnant, women. Am J Obstet Gynecol. 2005;193(3, pt 1):790–796
  32. Barcaite E, Bartusevicius A, Railaite DR, Nadisauskiene R. Vaginal misoprostol for cervical priming before hysteroscopy in perimenopausal and postmenopausal women. Int J Gynaecol Obstet. 2005;91:141–145
  33. Darwish AM, Ahmad AM, Mohammad AM. Cervical priming prior to operative hysteroscopy: a randomized comparison of laminaria versus misoprostol. Hum Reprod. 2004;19:2391–2394
  34. Fernandez H, Alby JD, Tournoux C, et al. Vaginal misoprostol for cervical ripening before operative hysteroscopy in pre-menopausal women: a double-blind, placebo-controlled trial with three dose regimens. Hum Reprod. 2004;19:1618–1621
  35. Ngai SW, Chan YM, Liu KL, Ho PC. Oral misoprostol for cervical priming in non-pregnant women. Hum Reprod. 1997;12:2373–2375
  36. Loffer FD. Complications of hysteroscopy: their cause, prevention, and correction. J Am Assoc Gynecol Laparosc. 1995;3:11–26
  37. Vilos GA, Vilos EC, King JH. Experience with 800 hysteroscopic endometrial ablations. J Am Assoc Gynecol Laparosc. 1996;4:33–38
  38. Thomas JA, Leyland N, Durand N, Windrim RC. The use of oral misoprostol as a cervical ripening agent in operative hysteroscopy: a double-blind, placebo-controlled trial. Am J Obstet Gynecol. 2002;186:876–879
  39. Preutthipan S, Herabutya Y. A randomized comparison of vaginal misoprostol and dinoprostone for cervical priming in nulliparous women before operative hysteroscopy. Fertil Steril. 2006;86:990–994
  40. Batukan C, Ozgun MT, Ozcelik B, Aygen E, Sahin Y, Turkyilmaz C. Cervical ripening before operative hysteroscopy in premenopausal women: a randomized, double-blind, placebo-controlled comparison of vaginal and oral misoprostol. Fertil Steril. 2008;89:966–973
  41. Oppegaard KS, Nesheim BI, Istre O, Qvigstad E. Comparison of self-administered vaginal misoprostol versus placebo for cervical ripening prior to operative hysteroscopy using a sequential trial design. BJOG. 2008;115:663;e1–663e9
  42. Singh N, Ghosh B, Naha M, Mittal S. Vaginal misoprostol for cervical priming prior to diagnostic hysteroscopy: efficacy, safety and patient satisfaction; a randomized controlled trial. Arch Gynecol Obstet. 2009;279:37–40
  43. Lin YH, Hwang JL, Seow KM, Huang LW, Chen HJ, Hsieh BC. Laminaria tent vs misoprostol for cervical priming before hysteroscopy: randomized study. J Minim Invasive Gynecol. 2009;16:708–712
  44. Mulayim B, Celik NY, Onalan G, Bagis T, Zeyneloglu HB. Sublingual misoprostol for cervical ripening before diagnostic hysteroscopy in premenopausal women: a randomized, double blind, placebo-controlled trial. Fertil Steril. 2009;93:2400–2404
  45. Ngai SW, Chan YM, Ho PC. The use of misoprostol prior to hysteroscopy in postmenopausal women. Hum Reprod. 2001;16:1486–1488
  46. Fung TM, Lam MH, Wong SF, Ho LC. A randomised placebo-controlled trial of vaginal misoprostol for cervical priming before hysteroscopy in postmenopausal women. BJOG. 2002;109:561–565
  47. da Costa AR, Pinto-Neto AM, Amorim M, Paiva LH, Scavuzzi A, Schettini J. Use of misoprostol prior to hysteroscopy in postmenopausal women: a randomized, placebo-controlled clinical trial. J Minim Invasive Gynecol. 2008;15:67–73
  48. Cooper KG, Pinion SB, Bhattacharya S, Parkin DE. The effects of the gonadotrophin releasing hormone analogue (goserelin) and prostaglandin E1 (misoprostol) on cervical resistance prior to transcervical resection of the endometrium. Br J Obstet Gynaecol. 1996;103:375–378
  49. Bisharah M, Al-Fozan H, Tulandi T. A randomized trial of sublingual misoprostol for cervical priming before hysteroscopy. J Am Assoc Gynecol Laparosc. 2003;10:390–391
  50. Waddell G, Desindes S, Takser L, Beauchemin MC, Bessette P. Cervical ripening using vaginal misoprostol before hysteroscopy: a double-blind randomized trial. J Minim Invasive Gynecol. 2008;15:739–744
  51. Ayla U, Emel Ebru O, Faika Ceylan S, Hulusi Bulent Z. Efficacy of vaginal misoprostol before hysteroscopy for cervical priming in patients who have undergone cesarean section and no vaginal deliveries. J Minim Invasive Gynecol. 2008;15:472–475
  52. Stjernholm Y, Sahlin L, Akerberg S, et al. Cervical ripening in humans: potential roles of estrogen, progesterone, and insulin-like growth factor-1. Am J Obstet Gynecol. 1996;174:1065–1071
  53. Norman M, Ekman G, Malmstrom A. Changed proteoglycan metabolism in human cervix immediately after spontaneous vaginal delivery. Obstet Gynecol. 1993;81:217–223
  54. Rajabi MR, Dodge GR, Solomon S, Poole AR. Immunochemical and immunohistochemical evidence of estrogen-mediated collagenolysis as a mechanism of cervical dilatation in the guinea pig at parturition. Endocrinology. 1991;128:371–378
  55. Atmaca R, Kafkasli A, Burak F, Germen AT. Priming effect of misoprostol on estrogen pretreated cervix in postmenopausal women. Tohoku J Exp Med. 2005;206:237–241
  56. Conn PM, Crowley WF. Gonadotropin-releasing hormone and its analogs. Annu Rev Med. 1994;45:391–405
  57. Genazzani AD, Petraglia F, Volpogni C, D'Ambrogio G, Facchinetti F, Genazzani AR. FSH secretory pattern and degree of concordance with LH in amenorrheic, fertile, and postmenopausal women. Am J Physiol. 1993;264(5, pt 1):E776–E781
  58. Troedsson MH, Desvousges A, Alghamdi AS, et al. Components in seminal plasma regulating sperm transport and elimination. Anim Reprod Sci. 2005;89:171–186
  59. Ni H, Sun T, Ma XH, Yang ZM. Expression and regulation of cytosolic prostaglandin E synthase in mouse uterus during the peri-implantation period. Biol Reprod. 2003;68:744–750
  60. Moslemizadeh N, Moghadam TG, Peyvandi S. Evaluation of vaginal misoprostol effect on pregnancy rate after intrauterine insemination. Pak J Biol Sci. 2009;12:64–68
  61. Billiet K, Dhont M, Vervaet C, et al. A multi-center prospective, randomized, double-blind trial studying the effect of misoprostol on the outcome of intrauterine insemination. Gynecol Obstet Invest. 2008;66:145–151
  62. Saav I, Aronsson A, Marions L, Stephansson O, Gemzell-Danielsson K. Cervical priming with sublingual misoprostol prior to insertion of an intrauterine device in nulliparous women: a randomized controlled trial. Hum Reprod. 2007;22:2647–2652
  63. Akerlund M, Stromberg P, Forsling ML. Primary dysmenorrhoea and vasopressin. Br J Obstet Gynaecol. 1979;86:484–487
  64. Yip SK, Tse AO, Haines CJ, Chung TK. Misoprostol's effect on uterine arterial blood flow and fetal heart rate in early pregnancy. Obstet Gynecol. 2000;95:232–235
  65. Kongnyuy EJ, Wiysonge CS. Interventions to reduce haemorrhage during myomectomy for fibroids. Cochrane Database Syst Rev. 2009;CD005355
  66. Gilles JM, Jacques E, Diro M, Burkett G. A real difference or creative summary measures?. Fertil Steril. 2004;81:1159–1160
  67. Fiala C, Gemzell-Danielsson K, Tang OS, von Hertzen H. Cervical priming with misoprostol prior to transcervical procedures. Int J Gynaecol Obstet. 2007;99(suppl 2):S168–S171
  68. Valente EP, de Amorim MM, Costa AA, de Miranda DV. Vaginal misoprostol prior to diagnostic hysteroscopy in patients of reproductive age: a randomized clinical trial. J Minim Invasive Gynecol. 2008;15:452–458

 The author has no commercial, proprietary, or financial interest in the products or companies described in this article.

PII: S1553-4650(10)00128-7

doi: 10.1016/j.jmig.2010.03.015

The Journal of Minimally Invasive Gynecology
Volume 17, Issue 4 , Pages 449-455 , July 2010

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