Misoprostol cervical ripening side effects. Doses not exceeding 25 mcg four-hourly of concern.

Design: Three hundred and ninety-six women with term pregnancies were randomised to receive either oral or vaginal misoprostol, or dinoprostone. 1 mm (±0. It is available as a cervical gel or controlled-release vaginal insert. Aims The aim of the present study was to evaluate the efficacy of 400 μg misoprostol administered orally, vaginally, or sublingually on cervical ripening before hysteroscopy Patients and methods Study setting: Sayed Galal Hospital. American College of Obstetricians and Gynecologists (ACOG) Recommendations: 25 mcg vaginally every 3 to 6 hours. 96, 95% CI 2. Objective: To perform hysteroscopy the cervix needs to be dilated and in nullipara and postmenopausal women this is sometimes difficult. The endocervical gel and vaginal inserts are agents for cervical ripening induction. 2 hr) as compared to the vaginal and oral routes. Expand Reviewer's conclusions: Vaginal misoprostol appears to be more effective than conventional methods of cervical ripening and labour induction. Jun 22, 2021 · Misoprostol modifies cervical collagen, resulting in cervical ripening, and also stimulates uterine activity. These mechanistic differences may affect outcomes in women treated with dinoprostone, a formulation identical to Apr 4, 2024 · Cervidil is an FDA-approved option for inducing labor. Aug 9, 2019 · To determine whether vaginal application of 40 mg isosorbide-5-mononitrate (ISMN) has a comparable cervical ripening efficacy to and lesser side effects than 400 µg misoprostol in women scheduled for the first trimester induced abortion using a manual vacuum aspirator (MVA). Some patients may require doses of 50 mcg every 6 hours; Comments: The manufacturer states that use outside of the approved indication should be reserved for hospital use only. Considering that the results of studies in this field are contradictory, it is the purpose of this study to evaluate the efficacy and safety of vaginal ISMN plus Jan 1, 2008 · Misoprostol has been authorised as an effective medication for termination of pregnancy at different gestations, cervical ripening, labour inducing in term pregnancy, and possibly therapy of Feb 21, 2015 · Cervical ripening is made possible by the use of medication through different routes [6] [7][8] the most commonly used agent is misoprostol, a synthetic prostaglandin E1 (PGE1) analogue that is Apr 15, 2021 · The adverse effects of misoprostol (e. 2. Overall, there were 75 trials (13,793 women); these were of mixed quality. Oct 17, 2022 · The two major techniques for cervical ripening are (1) mechanical interventions, such as insertion of a balloon catheter or, less commonly, hygroscopic cervical dilators, and (2) application of pharmacologic agents, such as prostaglandins. 0-1. 36 Studies have shown that the optimal dose in terms of balancing effectiveness and side effects is 400 µg. Filter by condition. Conclusion: Preoperative vaginal application of misoprostol before gynaecological procedures on non pregnant women decreases the cervical resistance, facilitates the cervical dilatation Jul 29, 2012 · The misoprostol cervical ripening effect on postmenopausal women was 4. Methods: This randomized controlled trial was conducted on 195 women with singleton pregnancies and unripe cervices. Background: This is one of a series of reviews of cervical ripening and labour induction using standardised methodology. 74), and vaginal misoprostol groups (p=0. Interpersonal techniques can prevent patients’ discomfort Mar 13, 2018 · 3. 3. It acts on the cervix by d. At much smaller doses, misoprostol is useful for cervical ripening and inducing labor in full-term pregnancies. 9. Low-dose (25 mcg) intravaginal misoprostol appears to be safe and effective for cervical ripening in term pregnancy for patients without a history of cesarean section Jan 1, 2023 · Health care providers can use prostaglandin E 1 for inpatient management of cervical ripening (strong, high). Some patients report an unpleasant taste of the misoprostol tablets or a short lasting numbness of the tongue if taken sublingually. To our knowledge, this is the first study to systematically compare outpatient cervical ripening to inpatient Objective: This study aimed to compare the effects of vaginal misoprostol, laminaria, and extra-amniotic saline infusion (EASI) on cervical ripening. Mar 19, 2014 · Ripening the cervix before curettage reduces commonness of these complications. Some patients report an unpleasant taste of the misoprostol tablets or a short lasting numbness of the tongue if taken This study helps derive a conclusion that vaginal misoprostol as a cervical priming agent in postmenopausal women appears to be safe, effective, and inexpensive, with mild side effects. Background: Misoprostol, a prostaglandin E1 analog, stimulates uterine contractility and cervical ripening. 6%, and 7. 5%, 16. 52, 95% CI 1. 2017). 018). Intravaginal misoprostol is an effective, easy to use and cheap drug for the induction of labour, especially for cervical ripening in women with unfavourable cervix, according to a evaluation of 64 women with indication for termination of pregnancy. Jun 10, 2024 · Background However, misoprostol is often used to terminate a pregnancy, but it can also cause side effects. 03 to 0. Misoprostol Feb 1, 1997 · TLDR. Other side effects are rare and fully reversible. Misoprostol, a synthetic prostaglandin E1 analogue, is commonly used for medical abortion, cervical priming, the management of miscarriage, induction of labor and the management of postpartum hemorrhage. Only nausea and vomiting were more frequent in post-menopausal misoprostol group than placebo (p = 0. Further research in postmenopausal women or those receiving GnRH agonists is also needed, to determine whether misoprostol is effective in cervical The time required to dilate the cervix in the misoprostol group was shorter, compared with placebo. Study duration: April 2017–April 2018. Doses not exceeding 25 mcg four-hourly of concern. Jun 5, 2023 · One 20 mg suppository is inserted into the posterior fornix of the vagina every three hours until abortion occurs. Participants were randomly allocated to 3, 65-person groups: a misoprostol, a Side-effects were more common in the misoprostol group (P = 0. Feb 19, 2024 · Cervical ripening and induction of labor: According to ACOG, vaginal misoprostol appears to be the most effective method of labor induction before 28 weeks of gestation. 7±1. Jul 1, 2004 · Misoprostol, a synthetic prostaglandin E 1 analogue widely prescribed for prevention and treatment of gastric ulcers, has been shown to have cervical ripening effects in both pregnant and non‐pregnant patients when administered either orally or vaginally ( Ngai et al. 7). 002) and postmenopausal women (P=0. Misoprostol can be obtained from the pyxis or pharmacy in pre-cut 25 mcg, and intact 100 and 200 mcg Other side effects are rare and fully reversible. 59, one RCT, 110 participants, low quality evidence). Feb 19, 2013 · Abstract. 6. w/ advancing gestational age and prior uterine surgery, incl. It was also found to Nov 22, 2021 · Several published studies of outpatient misoprostol for cervical ripening compared to expectant management or placebo suggest a reduction in time to the active phase of labor without significant increase in side effects [13-18]. Aug 29, 2022 · Misoprostol is one of the most studied agents in this context. Cervidil mimics the natural prostaglandins you have in the body that helps soften the cervix. Further studies are required to elucidate the most efficient option with the least side effects for cervical ripening. We found a clear effect of misoprostol on cervical ripening (two trials, average RR of unchanged cervix at 12 to 24 hours 0. Side effects were comparable between two groups. Endometrial biopsy and hysteroscopy are important investigations in women presenting with abnormal vaginal bleeding. , 1997 ; Preutthipan et al. Compared to osmotic dilatation (laminaria), misoprostol was associated with less effective cervical dilatation, with more women in the misoprostol group requiring mechanical dilatation (OR 5. Number of patients: 300 patients. Well-known, entry-related complications during hysteroscopy include Oct 6, 2010 · TLDR. Mechanism of cervical ripening had not been clearly defined. Apr 27, 2023 · However treatment side effects were more common in the misoprostol arm. Uterine hyperstimulation without FHR changes was increased (six trials, 794 women RR 3. cesarean delivery; do not use to decr. May 13, 2016 · On the other hand, the results on misoprostol alone before operative hysteroscopy in post-menopausal women are conflicting. Women who had had a previous caesarean section (CS Jul 13, 2023 · Common side effects, including fever, chills, and diarrhea, are not uncommonly noted with the use of substantially higher misoprostol doses, such as those used for early abortions. It’s primarily used to induce labor, man Apr 1, 2022 · Previous investigations were noted that Misoprostol is quite effective in cervical ripening. 5%, and 1. A torn uterus may result in severe bleeding, having the uterus removed May 1, 2006 · In premenopausal women, misoprostol appears to be promising as a cervical ripening agent prior to hysteroscopy, although further research is needed to identify the ideal dose, route, and timing. A few studies are available on the use of misoprostol for ripening the cervix prior to gynecological procedures on women. 05 to 0. 002). Expand. Prostaglandin E1 (PGE1) and prostaglandin E2 (PGE2) exert different effects on these processes and on myometrial contractility. Practical guidance on choosing the appropriate agent for cervical ripening and labor induction is provided via the use of clinical vignettes. Cytotec (misoprostol) is indicated for reducing the risk of NSAID (nonsteroidal anti-inflammatory drugs, including aspirin)–induced gastric ulcers in patients at high risk of complications from gastric ulcer, e. A similar effect on the nonpregnant uterus will facilitate gynecological operations, and hence we assessed the effect of misoprostol on the nonpregnant uterus of premenopausal women. Background: Misoprostol, the prostaglandin E1 analog, is increasingly used for cervical ripening and induction of labor. , low-grade fever, gastrointestinal symptoms) can be managed with nonsteroidal anti-inflammatory drugs or antiemetics. 006). Complications associated with prostaglandin administration were not statistically different between the two treatment groups. The apparent increase in uterine hyperstimulation is of concern. 8) in the placebo group; hence, further cervical dilatation was required in women of the placebo group, with a statistically significant difference between premenopausal (P=0. Misoprostol is a synthetic PGE1 analogue that is used for the treatment and prevention of peptic ulcers, but is useful for cervical ripening and labor induction. Occurrence of uterine false tract substantially increased in the placebo group. The cost of misoprostol ($0. Isosorbide mononitrate (ISMN) can help the cervix mature by increasing the production of prostaglandin E2 and vasodilation. aglandin El) is a commonly used pharmacologic agent used off-label for cervical ripening. Reports of adverse events such as cervical laceration or uterine perforation are uncommon overall in this body of evidence and no published study has investigated whether cervical preparation impacts these rare outcomes. Jan 12, 2023 · Below is a partial list of mild side effects of misoprostol. INDICATIONS AND USAGE. The use of medications for off-label purposes is legally permitted in Canada provided that the proposed use has been well-researched, there is peer support for the indication, and the risks and benefits of the proposed treatment Feb 19, 2024 · Misoprostol is used to terminate pregnancy in the second trimester as either monotherapy or combined with intramuscular methotrexate. 2% in the misoprostol group compared to 21. Cramp followed by vomiting and diarrhea were the most common side effects of misoprostol in the sublingual group, while cramp followed by vomiting was the most frequent side effect in the vaginal group. Instead of misoprostol, clinicians can use “verbicain” to ease IUD insertion. Pregnancy. NSAID ulcer risk in pregnant pts; advise pts of May 15, 2003 · However, little information is available about fetal outcomes and maternal side effects; thus, there is insufficient information to support the use of mifepristone for cervical ripening. Compared to osmotic dilatation (laminaria), misoprostol was associated with less effective cervical dilatation, with more However, misoprostol can cause more side effects such as shivering and vomiting. 2%) which were within tolerable limit. 014). It is effective in pregnant as well as in non-pregnant women See full list on my. 49; one trial; 96 women) and less likely to undergo caesarean birth (RR 0. 10 It is a synthetic analog of prostaglandin E1 that has been used for cervical preparation prior to performing hysteroscopy because it promotes effective cervical ripening, as well as being an inexpensive, easy to store and administer, and widely available method. Based on the American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin: Induction of Labor, misoprostol tablets administered intravaginally for cervical ripening and labor induction is effective and recommended in the management of this condition ACOG 107 2009. The woman should be informed of where to seek help if needed. Jun 5, 2017 · Purpose Prostaglandins play a critical role in cervical ripening by increasing inflammatory mediators in the cervix and inducing cervical remodeling. May 1, 2015 · However, the effects of misoprostol on cervical ripening in the perimenopausal and postmenopausal periods are controversial and have not been fully clarified (13). 37 There are data evaluating oral, vaginal, and sublingual routes of administration. May 30, 2020 · Misoprostol, the prostaglandin E1 analog, is increasingly used for cervical ripening and induction of labor. 05, RR 1. The study found that there was no significant difference in the amount of blood loss between the two drugs. 1. Brand names: Cytotec. Although complementary methods are occasionally used by patients, given the lack of data Sep 1, 2003 · This was a randomized, double blind, placebo-controlled trial to compare the efficacy and side effects of the two medications, isosorbide mononitrate and misoprostol, for cervical ripening before suction termination of first-trimester pregnancy. They measured things like the amount of blood loss and the occurrence of side effects. 21% of reviewers reported a positive experience, while 68% reported a negative experience. The studies were not large enough to exclude the possibility of rare but serious adverse effects, particularly uterine rupture Jul 27, 2021 · Background Being one of the most common indications of labor induction, postdate pregnancy can lead to serious maternal and fetal complications. 2, 3, 4 Unfortunately, except for the risk of uterine hyperstimulation that may compromise the fetus, its side effects are also the disadvantages of this drug. In this study we aimed to compare vaginal misoprostol with intracervical Foley catheter (FC) for cervical ripening in postdate primigravid women. These side effects are rare with the doses used for cervical ripening and labor induction. 2%, 29. The following symptoms may occur: diarrhoea, shivering, nausea, vomiting, increased body temperature and skin rash. , the elderly and patients with concomitant debilitating disease, as well as patients at high risk of developing gastric ulceration, such as patients with a Section 1: What is Misoprostol?Misoprostol, marketed under the name Misotac, is a synthetic prostaglandin E1 analog. It is more expensive than Cytotec and takes longer to work with a slow induction process. The studies were not large enough to exclude the possibility of rare but serious adverse effects, particularly uterine Sep 1, 2013 · Major conclusions: 400 μg vaginal misoprostol 3 h prior to office hysteroscopy appears to be more effective than 200 μg vaginal misoprostol in facilitating cervical ripening, minimizing pain Other side effects are rare and fully reversible. 5,6 The primary advantages of the drug include its thermostability, low cost, and the ease of administration Oct 6, 2010 · Secondary outcomes. If a break from cervical ripening is required, patients can be sent home from the hospital 2 hours after an oral dose and 4 hours after a vaginal dose if electronic fetal monitoring is normal (strong, moderate). There can be serious side effects, including a torn uterus (womb), when misoprostol is used for labor and delivery. Nov 30, 2022 · Usual Adult Dose for Cervical Ripening. Misoprostol for Cervical Ripening User Reviews. 3, 95% CI 1. Cervical priming with misoprostol has shown to facilitate transcervical procedures and to reduce side-effects. When used to promote cervical ripening and induce labor, misoprostol can be administered orally, rectally, sublingually, or vaginally. A number of randomized trials and systematic reviews have evaluated its use in Summary answer: The use of misoprostol at a dose of 400 µg administered vaginally 4 h prior to IUD insertion increased the ease of insertion and reduced the incidence of pain during the procedure, although the frequency of cramps increased following misoprostol use. In clinical use, PGE1 has the same limitations as other prostaglandins: it is rapidly metabolized, chemically unstable, and has numerous side effects [17]. Nowadays misoprostol has become a desirable agent due to its beneficial effects on cervical ripening on nonpregnant women (3–5). Side effects and patient satisfaction were the same for both treatment groups. Feb 17, 2020 · Cervical ripening and labor inductionyes. Conclusion: The study showed no benefit for use of misoprostol prior to IUD insertion. Clinical trial registration number: NCT01620814. Methods: Patients were selected for cervical ripening based on clinical profile. This study suggests that oral administration of misoprostol is an effective alternative to vaginal administration in the context of preinduction cervical ripening. Doses not exceeding 25 mcg four-hourly appeared to have similar effectiveness and risk . Dec 1, 2005 · Misoprostol for cervical ripening is an off-label use, but multiple studies have proved it to be safe and effective. Conclusions: The administration of misoprostol seemed more effective than the control for preoperative cervical priming in menstrual participants. Conclusions: Intravaginal administration of misoprostol appears to be as effective as intracervical dinoprostone for cervical ripening and labor induction. Therefore, we would not recommend standard pretreatment with misoprostol. , 1995, 1997). , 2002 ). Dec 11, 2018 · In fact, several studies found that patients who received misoprostol before IUD insertion had significantly more pain, along with higher rates of other side effects (including shivering and headache). Methods This randomized clinical trial included 120 primigravid women aged 18–35 years with singleton Misoprostol is a proven cervical ripening agent prior to first-trimester surgical abortion. Background: The induction of labor remains as one of the major challenges in obstetrics even in this modern era. Oct 18, 2004 · Abstract. Results: The mean time taken for cervical ripening was less in sublingual administration (3. Misoprostol administered by the oral and sublingual routes have the advantage of rapid onset of action, while the sublingual and vaginal routes have the advantage of prolonged activity and greatest bioavailability. In nine trials comparing oral misoprostol with placebo (1109 women), women using oral misoprostol were more likely to give birth vaginally within 24 hours (risk ratio (RR) 0. A Reviewer's conclusions: Although vaginal misoprostol appears to be more effective than conventional methods of cervical ripening and labour induction, the apparent increase in uterine hyperstimulation is of concern. Misoprostol is easy to store and stable at room temperature. 54 The efficacy of single- and double-balloon catheters in cervical ripening and labor induction seems similar. Objective: To compare the safety and efficacy of misoprostol with that of dinoprostone for the induction of labour at term, or near term. It can also be used off-label for cervical ripening (the process of opening and softening the cervix before labor) and to induce Dec 31, 2019 · of misoprostol for cervical dilatation can be oral, vaginal, or sublingual. use in pregnant women can cause birth defects, abortion, premature birth, or uterine rupture; uterine rupture reported w/ use to induce labor or abortion; risk of uterine rupture incr. To date, the combination of misoprostol with an intracervical catheter seems to be the best approach when balancing delivery times with safety. 16, 95% confidence interval (CI) 0. Misoprostol can be given for cervical ripening and labor induction at a dose of 25 mcg. May 15, 2024 · A review of drugs and pregnancy lists Moebius sequence as a potential complication of misoprostol use. Conclusion: Stepwise oral misoprostol (50 microg followed by 100 microg) appears to be as effective as vaginal misoprostol (25 microg) for cervical ripening with a low incidence of hyperstimulation, no increase in side effects, a high rate of patient satisfaction, and is associated with a lower cesarean section rate. Difficulty in entering Oct 23, 2012 · However, the incidence of side effects, such as preoperative vaginal bleeding, was increased in the vaginal group compared to the oral misoprostol group. Jun 13, 2014 · Main results. These recommendations are produced by an expert Apr 3, 2006 · Misoprostol, a synthetic prostaglandin E1 analogue, has been demonstrated to have cervical ripening effects in both pregnant and non-pregnant patients (Ngai et al. 24). 72, 95% CI 0. 5 out of 10 from a total of 28 reviews for the off-label treatment of Cervical Ripening. , the elderly and patients with concomitant debilitating disease, as well as patients at high risk of developing gastric ulceration, such as patients with a Abstract. The ideal priming agent is one that causes cervical change that is most similar to that seen in natural ripening process Misoprostol (PGE 1) is a highly effective pharmacologic agent for both cervical ripening and induction of labour. It has been reported that a pretreatment with vaginal estradiol enhances the effects of vaginal misoprostol on cervical dilatation in postmenopausal women [11,12]. ssolving collagen bundles and increasing water content of the tissue (Wing, et al. These techniques will be reviewed in this topic. Furthermore, parity (nulliparous or parous), means of delivery (vaginal delivery or cesarean section), and estrogen status also impact the effect of misoprostol on cervical ripening Misoprostol is a more efficacious cervical ripening and labor inducing agent compared to dinoprostone gel and can be used safely in the North Indian setting. If the abortion does not occur within twenty-four hours, or if there are severe side effects, the clinician should stop the drug. 001) and the duration of SE was less as compared to the vaginal and oral routes. The S/L group had significant cervical dilatation (P<0. Oct 26, 2007 · Misoprostol, a synthetic prostaglandin E1 analogue, is commonly used for medical abortion, cervical priming, the management of miscarriage, induction of labor and the management of postpartum hemorrhage. Meanwhile, the risk of side-effects increased in the misoprostol-treated patients compared to the control group. Further Polyzos et al concluded that misoprostol may have a role as a cervical-ripening agent prior to hysteroscopy, and the efficacy of misoprostol is related to the menopausal status of patients. [24291] Serious adverse events have been reported following the use of misoprostol in pregnant women for off-label uses such as termination of pregnancy, cervical ripening, or labor induction. Aug 5, 2020 · Uses for Cytotec. Endometrial biopsy is often performed as an outpatient procedure by endometrial aspiration. Early pregnancy lossbyes Conclusion(s): Vaginally administered dinoprostone before diagnostic hysteroscopy is more effective than misoprostol for inducing cervical priming. The study looked at 13 different studies with over 24,000 women. , 2000 ). 32 RELAXIN Oct 29, 2018 · This narrative review focuses primarily on pharmacologic methods of cervical ripening and labor induction, highlighting the differences between the prostaglandin preparations dinoprostone and misoprostol. It can be given orally, vaginally, sublingually, buccally or rectally. 99). clevelandclinic. org Apr 23, 2015 · However treatment side effects were more common in the misoprostol arm. 3, 5, 6 To avoid hazards surrounding the use of Misoprostol, researchers have shown an Abstract. Modern methods of cervical ripening are generally safe, although efficacy and side-effects between methods vary. To conclude, this study helps derive a conclusion that vaginal misoprostol as a cervical priming agent in postmenopausal women appears to be safe, effective, and inexpensive, with mild side effects. Misoprostol has an average rating of 3. Misoprostol can be administered either orally or vaginally ( Ngai et al . [1] Clinicians also use misoprostol as expectant management of missed and incomplete abortions. The most common routes of administration for labour induction are oral and vaginal. 9) compared with 3. 61 to 13. What is known and what this paper adds: Misoprostol has been widely used in Two most common side effects of vaginal misoprostol were mild lower abdominal pain (21%) and slight vaginal bleeding (09. Conclusion: Four hundred micrograms of oral misoprostol 12 h prior to dilation and curettage was found to be beneficial in cervical priming in pre-menopausal subjects. The results showed that, compared with placebo or no medication, the use of misoprostol prior to hysteroscopy led to a significant relief of the need for cervical dilatation, resulted in a significantly greater cervical width, had fewer hysteroscope complications, and mild and insignificant side effects. However, there is a tendency of possible harm regarding side-effects. The frequency of misoprostol administration should not exceed 3 to 6 hours. General issues regarding induction of labor and use of Background: Misoprostol is very effective in cervical ripening and is used for termination of pregnancy. 36/100 micrograms) is much less than There were more side effects in the misoprostol group. 3%, respectively, in the dinoprostone group. 2 mm (±0. Median Hegar number passed into the cervix without resistance was 5 in sublingual versus 4 in vaginal group (P = 0. Cervical priming is recommended by several evidence-based guidelines prior to surgical abortion, dilatation and curettage, hysteroscopy and intrauterine device insertion. Misoprostol results in reduced risk of not achieving vaginal birth within 24 hours; reduces need for oxytocin augmentation; reduces risk Sep 6, 2016 · Misoprostol, a prostaglandin E1 analog, which was initially used for the treatment of peptic ulcers, has been widely applied in obstetrics and gynecology because of its ripening effect on cervix during the induction of abortion or labor. We found significant differences between the study and control groups with respect to the number of women who required cervical dilatation. Such side effects include maternal or fetal death acid, the active drug [17]. The significant difference of side effects between the two groups were abdominal pain, vaginal bleeding, and feeling feverish, which occurred in 36. g. that causes cervical ripening and Reviewer's conclusions: Vaginal misoprostol appears to be more effective in inducing labour than conventional methods of cervical ripening and labour induction. Feb 1, 2006 · Evidence-Based Answer. 41 Whereas our meta-analysis shows that the efficacy of misoprostol is related to the type of hysteroscopy and route of administration. Cervical priming with misoprostol administered orally or vaginally 3 h before MVA for termination of pregnancy under local anesthesia facilitates the procedure by decreasing the need for cervical dilatation and by shortening its duration without improving patients' pain perception and satisfaction mainly due to side effects. We evaluated our experience with misoprostol in an open-label setting. 62), and gastrointestinal side effects were significantly more in the oral misoprostol group (p=0. 09, 95% confidence interval (CI) 0. Mar 1, 2011 · The tolerability was noted on the basis of side effects. At 3 cm cervical dilation, misoprostol was discontinued and A 2015 systematic review concluded that use of misoprostol for preoperative ripening is more effective than placebo or no treatment and is associated with fewer intraoperative complications; however, it is associated with a higher rate of adverse effects, including mild abdominal pain, increased body temperature, and vaginal bleeding 7. Nov 1, 1997 · Oral misoprostol is effective for pre-operative cervical dilatation in non-pregnant women before hysteroscopy in women presenting with abnormal vaginal bleeding. 78 to 6. , 1997 ; Preutthipan and Herabutya, 1999 , 2000 ; Thomas et al . There were no significant differences in the amount of blood loss between oral (p=0. Several routes of administration exist: oral, vaginal, rectal, buccal (dissolved in the cheek) and sublingual (dissolved under the tongue). aj kb ol nc el mg nc wm br xj