Comparative Study of the Effects of Sublingual Trinitroglycerin and Sublingual Misoprostol on Cervical Preparation before Hysteroscopy: A Randomized Controlled Trial
Background: Hysteroscopy is a valuable surgical technique, but some complications are related to cervical dilatation. Sublingual trinitroglycerin (TNG) is a vasodilator that can facilitate cervical dilation. In our study, we compared its effectiveness to that of misoprostol. Methods: This randomized...
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IMR Press
2024-07-01
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| Series: | Clinical and Experimental Obstetrics & Gynecology |
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| Online Access: | https://www.imrpress.com/journal/CEOG/51/7/10.31083/j.ceog5107167 |
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| author | Shahla Mirgaloybayat Mahmoodreza Madadian Kobra Tahermanesh Roya Derakhshan Saeedeh Sarhadi Samaneh Rokhgireh |
| author_facet | Shahla Mirgaloybayat Mahmoodreza Madadian Kobra Tahermanesh Roya Derakhshan Saeedeh Sarhadi Samaneh Rokhgireh |
| author_sort | Shahla Mirgaloybayat |
| collection | DOAJ |
| description | Background: Hysteroscopy is a valuable surgical technique, but some complications are related to cervical dilatation. Sublingual trinitroglycerin (TNG) is a vasodilator that can facilitate cervical dilation. In our study, we compared its effectiveness to that of misoprostol. Methods: This randomized controlled trial study was conducted on 199 women of reproductive age who were referred to Rasoul Akram Hospital. Patients were randomly divided into two groups: TNG and misoprostol. Next, they were examined for clinical and practical indicators of cervical preparation. The data was analyzed using SPSS software. Results: Demographic characteristics exhibited no significant differences between the groups. The mean size of the largest dilator inserted without resistance showed not statistically significant difference between the TNG and misoprostol groups (6.26 ± 1.95 vs. 6.57 ± 2.05; p = 0.20). Side effects were reported in 66 (33.2%) of the women studied. The misoprostol group experienced a significantly higher rate of side effects (53.7%) compared to the TNG group (14.4%; p < 0.001). The most frequently observed side effect in the TNG group was headache, which occurred at a statistically significantly higher rate than in the misoprostol group (p = 0.04). On the other hand, uterine bleeding before hysteroscopy was significantly lower in the TNG group compared to the misoprostol group (p < 0.001). Conclusions: There was no statistically significant difference in the mean size of the largest dilator inserted without resistance between the TNG and misoprostol groups. Additionally, TNG experienced significantly fewer side effects than sublingual misoprostol group, with headache being the most prominent side effect. Sublingual TNG can be used to improve cervical preparation before hysteroscopy. Clinical Trial Registration: The study has been registered on https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT20191123045476N4 (registration number: IRCT20191123045476N4). |
| format | Article |
| id | doaj-art-dc0cd9a60fef4d5991b7002a5cb6b2e0 |
| institution | DOAJ |
| issn | 0390-6663 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | IMR Press |
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| series | Clinical and Experimental Obstetrics & Gynecology |
| spelling | doaj-art-dc0cd9a60fef4d5991b7002a5cb6b2e02025-08-20T03:23:57ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-07-0151716710.31083/j.ceog5107167S0390-6663(24)02403-5Comparative Study of the Effects of Sublingual Trinitroglycerin and Sublingual Misoprostol on Cervical Preparation before Hysteroscopy: A Randomized Controlled TrialShahla Mirgaloybayat0Mahmoodreza Madadian1Kobra Tahermanesh2Roya Derakhshan3Saeedeh Sarhadi4Samaneh Rokhgireh5Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, 1449614535 Tehran, IranDepartment of Faculty of Pharmacy, Islamic Azad University, 1941933111 Tehran, IranEndometriosis Research Center, Iran University of Medical Sciences, 1449614535 Tehran, IranEndometriosis Research Center, Iran University of Medical Sciences, 1449614535 Tehran, IranHealth Promotion Research Center, Zahedan University of Medical Sciences, 9816743463 Zahedan, IranEndometriosis Research Center, Iran University of Medical Sciences, 1449614535 Tehran, IranBackground: Hysteroscopy is a valuable surgical technique, but some complications are related to cervical dilatation. Sublingual trinitroglycerin (TNG) is a vasodilator that can facilitate cervical dilation. In our study, we compared its effectiveness to that of misoprostol. Methods: This randomized controlled trial study was conducted on 199 women of reproductive age who were referred to Rasoul Akram Hospital. Patients were randomly divided into two groups: TNG and misoprostol. Next, they were examined for clinical and practical indicators of cervical preparation. The data was analyzed using SPSS software. Results: Demographic characteristics exhibited no significant differences between the groups. The mean size of the largest dilator inserted without resistance showed not statistically significant difference between the TNG and misoprostol groups (6.26 ± 1.95 vs. 6.57 ± 2.05; p = 0.20). Side effects were reported in 66 (33.2%) of the women studied. The misoprostol group experienced a significantly higher rate of side effects (53.7%) compared to the TNG group (14.4%; p < 0.001). The most frequently observed side effect in the TNG group was headache, which occurred at a statistically significantly higher rate than in the misoprostol group (p = 0.04). On the other hand, uterine bleeding before hysteroscopy was significantly lower in the TNG group compared to the misoprostol group (p < 0.001). Conclusions: There was no statistically significant difference in the mean size of the largest dilator inserted without resistance between the TNG and misoprostol groups. Additionally, TNG experienced significantly fewer side effects than sublingual misoprostol group, with headache being the most prominent side effect. Sublingual TNG can be used to improve cervical preparation before hysteroscopy. Clinical Trial Registration: The study has been registered on https://trialsearch.who.int/Trial2.aspx?TrialID=IRCT20191123045476N4 (registration number: IRCT20191123045476N4).https://www.imrpress.com/journal/CEOG/51/7/10.31083/j.ceog5107167cervical ripeningmisoprostolhysteroscopytrinitroglycerin |
| spellingShingle | Shahla Mirgaloybayat Mahmoodreza Madadian Kobra Tahermanesh Roya Derakhshan Saeedeh Sarhadi Samaneh Rokhgireh Comparative Study of the Effects of Sublingual Trinitroglycerin and Sublingual Misoprostol on Cervical Preparation before Hysteroscopy: A Randomized Controlled Trial Clinical and Experimental Obstetrics & Gynecology cervical ripening misoprostol hysteroscopy trinitroglycerin |
| title | Comparative Study of the Effects of Sublingual Trinitroglycerin and Sublingual Misoprostol on Cervical Preparation before Hysteroscopy: A Randomized Controlled Trial |
| title_full | Comparative Study of the Effects of Sublingual Trinitroglycerin and Sublingual Misoprostol on Cervical Preparation before Hysteroscopy: A Randomized Controlled Trial |
| title_fullStr | Comparative Study of the Effects of Sublingual Trinitroglycerin and Sublingual Misoprostol on Cervical Preparation before Hysteroscopy: A Randomized Controlled Trial |
| title_full_unstemmed | Comparative Study of the Effects of Sublingual Trinitroglycerin and Sublingual Misoprostol on Cervical Preparation before Hysteroscopy: A Randomized Controlled Trial |
| title_short | Comparative Study of the Effects of Sublingual Trinitroglycerin and Sublingual Misoprostol on Cervical Preparation before Hysteroscopy: A Randomized Controlled Trial |
| title_sort | comparative study of the effects of sublingual trinitroglycerin and sublingual misoprostol on cervical preparation before hysteroscopy a randomized controlled trial |
| topic | cervical ripening misoprostol hysteroscopy trinitroglycerin |
| url | https://www.imrpress.com/journal/CEOG/51/7/10.31083/j.ceog5107167 |
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