Laminaria Tent vs Misoprostol for Cervical Priming before Hysteroscopy: Randomized Study

Study Objective: To compare the efficacy of laminaria tents and orally administered misoprostol in priming the cervix before operative hysteroscopy. Design: Randomized, controlled study (Canadian Task Force classification I). Setting: Tertiary medical center. Patients: One hundred twenty premenopausal women who underwent operative hysteroscopy between March 2005 and January 2007. Intervention: The women were randomized to receive a laminaria tent or misoprostol for cervical priming. Measurements and Main Results: The primary outcomes were postpriming cervical width insofar as size of Hegar dilators and need for cervical dilation. The secondary outcomes were adverse effects from the priming methods. Postpriming cervical width was greater in the laminaria group but not significantly different from that in the misoprostol group. However, cervical dilation before hysteroscopy was required in more patients in the misoprostol group. Nausea, vomiting, diarrhea, and bleeding were more common in the misoprostol group, and the incidences of chills and headache were similar between the 2 groups. Conclusion: Laminaria tents are superior to oral misoprostol insofar as less need for cervical dilation and fewer adverse effects.