Comparison of Effect of Oxytocin and Prostaglandin E1 on Cervix Prior to Curettage in First Trimester

Document Type : Original Article

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

2 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

3 Resident of Obstetrics and Gynecology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Abstract

Introduction: In missed abortion, expulsion of the conceptus does not occur despite a prolonged period after embryonic death. Coagulation defects due to retention of a dead fetus are rare, however expectant management, can cause anxiety and many women prefer to have the uterus evacuated. For decreased complication and simplicity of curettage, it is better to ripening the cervix. This study designed to compare the efficacy of oxytocin and misoprostol for cervical ripening in first trimester in patient with missed abortion.
Methods: In this clinical application study, 126 patients participated who admitted for evacuation of missed abortion in Imam Khomeini and Razi hospitals in Ahvaz, Iran 2006-2007. Patients were randomly assigned to two groups having 63 patients in each group. Primary dilatation of cervix measured with dilator .One group (group I) was given intravenous infusion of 50U oxytocin in 1000cc ringer in 8 hour from 12 midnight until 8 Am, at a rate of 40 drops in minute. Another group (group II) was given 200µg intravaginal misoprostol at 12 midnight. Dilatation of cervix measured before curettage between two groups and then compared. Data statistically analyzed by using SPSS software version 11, t-test and paired t-test. P value less than 0.05 was considered statistically significant.
Results: Mean age of patient was 27±6.08 in range of 15-47 years. The mean of dilatation in group I was 2.5 mm (49%) and group II was 4 mm (76%) and two groups had significant difference (p<0.001). In patients who receive oxytocin, there is no significant difference in cervical dilatation between nulliparous and multiparous, but in patients who receive misoprostol, the cervical dilatation had significant difference between these two groups (p<0/001).
Conclusion: Oxytocin and misoprostol are effective for ripening of cervix before curettage, but misoprostol is more effective than oxytocin.

Keywords


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