Comparative Efficacy and Acceptability Profile of Prostaglandin E1, Nitric Oxide Donors and their combination in Pre-Operative Cervical Priming for Surgical Evacuation of Missed Miscarriages: A Randomised Controlled Trial
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Background: Cervical ripening is an essential pre requisite for surgical evacuation in missed miscarriages. This requires an agent that can ripen the cervix effectively with minimal adverse effects. Patients & Methods: In this three group randomised controlled trial we have compared group M (misoprostol 400µg), group – I (40mg Isosorbide mono nitrate – ISMN) and group – C (combination of misoprostol 400µg and 40mg ISMN). All patients were administered the drug at zero hour and were assessed for desired dilatation which was taken as easy negotiation of a Hegar dilator – 10 (HD-10). They were assessed every 3 hours and those with ripened cervix were taken for surgical evacuation. Those who didn’t meet the end point were again administered the drug/s. Intra-operative blood loss and procedural time were noted. Adverse effects were recorded. Results: Statistically significant difference was noted at each assessment with maximum dilatation in group – C and least in group – I. No of doses were also least in group – C and maximum in group – I. Adverse effects were least in ISMN, followed by combination and were highest in misoprostol. Conclusion: Combination appears to synergistically improve therapeutic benefits and reduce the adverse events.
Authors and Affiliations
Amatunnafe Naseha, Mohammed Ismail Khan, Asna Yasmeen
Keywords
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- EP ID EP244093
- DOI 10.9790/0853-1610076775
- Views 56
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