EFFICACY AND SAFETY OF SUBLINGUAL MISOPROSTOL FOR CERVICAL PRIMING BEFORE MINOR GYNECOLOGICAL PROCEDURES

OBJECTIVE To assess the efficacy and safety of 400 micrograms of sublingual misoprostol in comparison to the same dose of vaginal misoprostol for cervical priming before minor gynecological procedures. MATERIALS AND METHODS The Randomized Controlled Trial was conducted in Khyber Teaching Hospital from 1st April 2021 to 31st Oct 2022. The sample size was 212, and a convenient random sampling technique was used. Fifty percent of the patients were given sublingual misoprostol 400 micrograms 2 hours before surgery (group A), while the rest were given 400 micrograms vaginal misoprostol 4 hours before surgery (group B). Efficacy of procedure was defined as the measure of pre-procedural cervical width as measured by the largest number of cervical Hagar’s dilators passing easily through the cervix. At the same time, safety was the measure of less or no occurrence of side effects related to misoprostol and procedure, such as fever, chills, vomiting, diarrhea, vaginal bleeding, cervical injury, or uterine perforation. All data was stored and analyzed in SPSS 20. RESULTS The mean age of patients in group A was 38.99 ± 7.82, and in group B 37.97 ± 7.30, The Mean parity in group A 2.98 ± 2.32 and in group B was 3.05 ± 1.67, Mean uterine size in group A 10.83 ± 1.80 and in group B 9.93 ± 1.81, and the mean pre-procedural cervical width in mm in group A was 8.57 ± 0.74 and in group B 8.01 ± 0.41(p-value 0.002). Complications included minor side effects like nausea and uterine cramps. CONCLUSION Sublingual misoprostol is an effective and safe agent for cervical ripening and dilatation before minor gynecological procedures. The effect of sublingual misoprostol 2 hours before the minor procedures is more effective compared to the same dose of vaginal misoprostol when given 4 hours prior. KEYWORDS Misoprostol, Sublingual, Cervical width, cervical priming, minor gynecological procedures.