Which route of misoprostol application is more advantageous prior to fractional curettage in postmenopausal patients?

PURPOSE: To determine the effectiveness and potential side effects of oral, vaginal, and sublingual intake of misoprostol on cervical dilatation prior to fractional curettage in patients with postmenopausal bleeding.

METHODS

Seventy-six patients with postmenopausal bleeding during a period of 18 months were included in this randomized controlled trial. Patients were given 400 microg of misoprostol through the vaginal, oral, and sublingual routes, 12 h prior to the fractional curettage procedure. The degree of cervical dilatation, duration of the procedure, the side effects and complications were noted.

RESULTS

When compared with the control group, misoprostol administered orally or sublingually was found to have a significant effect on cervical dilatation (P < 0.05). Of the three groups, nausea was found to be more common in the orally administered misoprostol group.

CONCLUSIONS

We conclude that the oral or sublingual application of misoprostol prior to fractional curettage in patients with postmenopausal bleeding decreases the need for cervical dilatation.