Buccal misoprostol plus laminaria for cervical preparation before dilation and evacuation at 21-23 weeks of gestation: a randomized controlled trial.
Contraception
; 89(4): 307-13, 2014 Apr.
Article
em En
| MEDLINE
| ID: mdl-24560477
ABSTRACT
OBJECTIVE:
To describe the effectiveness of buccal misoprostol as an adjunct to laminaria for cervical ripening before later second-trimester abortion by dilation and evacuation (D&E).METHODS:
A randomized, double-blinded, placebo-controlled trial of 196 women undergoing D&E between 21 and 23 weeks of gestation. Subjects had overnight laminaria and 400 mcg buccal misoprostol or placebo 3-4 h before the abortion. We used logarithmic transformation of the primary outcome--D&E procedure duration--to achieve a normal distribution.RESULTS:
Mean D&E duration was 1.7 min shorter with misoprostol (p=.02). The median duration was 9.7 versus 10.4 min in the misoprostol and placebo groups, respectively (p=.09). Cervical dilation was slightly greater with misoprostol (median 75 mm vs. 73 mm, p=.04); however, physicians did not find the misoprostol D&Es easier to complete. Half of subjects reported severe pain after misoprostol vs. 11% with placebo (p<.001).CONCLUSION:
Adjuvant buccal misoprostol results in slightly shorter D&Es at the cost of more side effects.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Abortivos não Esteroides
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Misoprostol
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Aborto Induzido
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Maturidade Cervical
Tipo de estudo:
Clinical_trials
Limite:
Adult
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Female
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Humans
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Pregnancy
Idioma:
En
Revista:
Contraception
Ano de publicação:
2014
Tipo de documento:
Article