Obstetrics and Gynecology
maryam dehghan; tajosadat alameh; Zahra Allameh; zahra Seyed-Hoseini
Volume 8, Issue 2 , March and April 2023, , Pages 113-119
Abstract
Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly ...
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Background & Objective: The aim of this study was to compare the efficacy of vaginal misoprostol with Foley balloon catheter for cervical ripening in women with singleton pregnancies and an unfavorable cervix.Materials & Methods: Eighty pregnant women with unfavorable cervix were randomly divided in two groups of Foley catheter or misoprostol modes. Cervical ripening in Foley catheter group was done with transcervical Foley catheter 18, and in misoprostol group with 25 μg single dose vaginal misoprostol (The maximum allowed dose for patients was 6 doses.). Bishop score, Apgar score, active phase duration, stage 2 duration and insertion to delivery interval were the main outcomes.Results: The mean time of ripening and the active phase in vaginal misoprostol group was significantly shorter than in Foley catheter group (2.32 versus 5.11 hours respectively, P-value = 0.0001). After intervention, Bishop score in vaginal misoprostol group was significantly more than Foley catheter group (8.70 versus 6.68 respectively, P-value = 0.0001). Insertion to delivery interval in vaginal misoprostol group was 9.54 hours and in Foley catheter group was 12.88 hours (P-value = 0.0001). The hospitalization time in Foley catheter group was significantly more than vaginal misoprostol group (P-value = 0.0001). The other outcomes were similar between groups.Conclusion: By the decreasing in the total time from insertion to birth, vaginal misoprostol was more effective than Foley catheter, as a cervical ripening method in our study.
Obstetrics and Gynecology
Soheila Aminimoghaddam
Volume 7, Issue 4 , March and April 2022, , Pages 358-360
Abstract
Response to the editor letter Dear Professor Behtash,I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered ...
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Response to the editor letter Dear Professor Behtash,I am writing this letter to respond to the letter written by Professor Reda Hemida from Mansoura University, Egypt, regarding a publication of mine titled “The Association of Gestational Trophoblastic Neoplasia and Misoprostol Administered Before Suction Curettage of Molar Pregnancy,” published in 2019 in your journal.I want to first thank Professor Hemida for reading my paper carefully and sharing his comments. I highly believe that sharing comments and raising scientific questions could benefit our society. I hope that the responses that the co-authors have provided be helpful and to the point. As he suggested, I am willing to let the journal publish the responses in the next issue.
General Gynecology and Pelvic Floor
Behnaz Nouri; Ahmad Reza Baghestani; Paricheher Pooransari
Volume 6, Issue 2 , March 2021, , Pages 87-94
Abstract
Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial ...
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Backround and Objective: Cervical ripening/dilatation is necessary for gynecologic procedures, but pharmacological dilators have several adverse effects. In this regard, evening primrose oil (EPO) has been shown as an effective dilator, though it has few complications. This randomized clinical trial (RCT) aimed to compare the effect of EPO and misoprostol on cervical ripening/dilatation.Methods: In this double–blind RCT study, women of reproductive age without history of normal vaginal delivery (NVD) and menopause women (age range: 20–75 years) were enrolled. The subjects who were candidates of hysteroscopy, dilatation, and curettage were randomly assigned into two groups. In one group, 2 capsules of 500 mg EPO (N=81) and in the other group 2 capsules of 200 µg misoprostol (N=84) were placed in posterior fornix 2 hours before surgery. The time to reach complete dilatation (Hegar 3 to 10 mm), size of the first Hegar used to apply force, bleeding volume, and cervical laceration were compared between the groups using the IBM SPSS Statistics for Windows, Version 21.0 (Armonk, NY: IBM Corp).Results: The two study groups had similar demographic information, number of pregnancies, cesarean sections, and NVDs (P < /em>>.05), but had different frequency of surgical types (P < /em>=.018). EPO group had a larger mean size of the Hegar (7.32 vs. 6.58 mm; P < /em>=.004) and shorter time to reach complete dilatation (242.35 vs. 331.79 min; P < /em>=.002); however, bleeding volume and frequency of cervical laceration were not different between the groups (1.41 vs. 2.00 cc and 8.6% vs. 14.3%, respectively; P < /em>>.05).Conclusion: The superiority of EPO capsules to misoprostol for cervical ripening before gynecologic procedures in women of reproductive age without history of normal NVD and menopause women suggests it as an appropriate alternative to misoprostol.
Soheila Aminimoghaddam; Afsar Ahmad; Setare Nassiri
Volume 4, Issue 3 , September and October 2019, , Pages 111-116
Abstract
Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 ...
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Background & Objective: Gestational trophoblastic neoplasia contains a group of abnormal trophoblastic tumors including hydatidiform moles (partial and complete) and non-molar trophoblastic neoplasms (invasive mole, choriocarcinoma, placental site trophoblastic tumor). The incidence is 1-2 per 1000 deliveries both in the United States and Europe. The aim of this study was to prove the noninferiuority and safety of misoprostol use in cervical ripening in patient with molar pregnancy.
Materials & Methods: This retrospective cohort study was performed on 150 women with molar pregnancy referred to Firuzgar and Mirza-koochack-khan hospitals in Tehran, between 2006 and 2013. We defined group 1 as 100 patients without Misoprostol pretreatment and group 2 as 50 patients with Misoprostol pretreatment. There was no significant difference in the number of complete or partial mole between the two groups. They were followed by serum ß-hCG level and if it became plateaued in 4 measurements or rose more than 10% in 3 measurements in a period of three weeks, would be defined as persistent.
Results: We found no significant difference of maternal age, fundal height, gestational age, gravity, parity, number of previous abortions and prevalence of complete and partial moles between the two groups. A total of 27 (27%) patients in non-Misoprostol group and 5 (10%) patients in Misoprostol group developed Persistent GTN (P < /em><0.05). We observed no case of trophoblastic embolism in the misoprostol group.
Conclusion: Misoprostol cervical ripening resulted in lower Persistent GTN incidence. Also, trophoblastic embolism following misoprostol administration is so rare that we observed no case.
