Moistening the new vaginal misoprostol tablets: does it increase the efficacy of cervical priming before manual vacuum aspiration in first-trimester miscarriage? A randomised clinical trial

References

• World Health Organization, Regional Office for Europe. Definitions and indicators in Family Planning Maternal & Child Health and Reproductive Health used in the WHO Regional Office for Europe. Copenhagen: WHO Regional Office for Europe 2000.
   Google Scholar
• Regan L, Rai R. Epidemiology and the medical causes of miscarriage. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000;14:839–854.
   PubMed Web of Science ®Google Scholar
• Grimes DA, Benson J, Singh S, et al. Unsafe abortion: the preventable pandemic. Lancet. 2006;368:1908–1919.
   PubMed Web of Science ®Google Scholar
• Royal College of Obstetricians and Gynaecologists. Ectopic pregnancy and miscarriage: diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage. London: RCOG; 2013.
   Google Scholar
• American College of Obstetricians and Gynecologists. ACOG practice bulletin. Clinical management guidelines of obstetrician–gynecologists. Number 67, October 2005. Medical management of abortion. Obstet Gynecol. 2005;106:871–882.
   PubMedGoogle Scholar
• FEBRASGO. Tratado de obstetricia. São Paulo: Revinter 2000.
   Google Scholar
• Webber K, Grivell RM. Cervical ripening before first trimester surgical evacuation for non-viable pregnancy. Cochrane Database Syst Rev. 2015;11:CD009954.
   Google Scholar
• Goldberg AB, Allen RH. Misoprostol before first trimester surgical abortion: a patient-centered approach. Contraception. 2016;94:576–577.
   PubMed Web of Science ®Google Scholar
• Grossman D, Constant D, Lince-Deroche N, et al. A randomized trial of misoprostol versus laminaria before dilation and evacuation in South Africa. Contraception. 2014;90:234–241.
   PubMed Web of Science ®Google Scholar
• Ahmed SU, Mahajan RR, Vaginal tablets comprising misoprostol and methods of making and using the same US 8148560 B2. Available at: www.google.ch/patents/US8148560 [cited 2016 Apr 7].
   Google Scholar
• Chen D, Lin HI, Lu SB, et al. Improved stabilization of misoprostol EP 0896823 B1. Available at: www.google.com/patents/EP0896823B1?cl=en [cited 2016 Apr 7].
   Google Scholar
• Selvaraj S, Elumalai B, Arunachalam M, et al. Misoprostol dispersible tablet EP 2965750. Available at: https://data.epo.org/publication-server/rest/v1.0/publication-dates/20160113/patents/EP2965750NWA1/document.pdf [cited 2016 Apr 7].
   Google Scholar
• Gilles JM, Creinin MD, Kurt B, et al. A randomized trial of saline solution–moistened misoprostol versus dry misoprostol for first-trimester pregnancy failure. Am J Obstet Gynecol. 2004;190:389–394.
   PubMed Web of Science ®Google Scholar
• Hebron. Prostokos (misoprostol). Available at: www.anvisa.gov.br/datavisa/fila_bula/frmVisualizarBula.asp?pNuTransacao=10359822014&pIdAnexo=2312985 [cited 2016 Dec 24].
   Google Scholar
• Fong YF, Singh K, Prasad RN. A comparative study using two dose regimens (200 microg or 400 microg) of vaginal misoprostol for pre-operative cervical dilatation in first trimester nulliparae. BJOG. 1998;105:413–417.
   Google Scholar
• Creinin MD, Carbonell JL, Schwartz JL, et al. A randomized trial of the effect of moistening misoprostol before vaginal administration when used with methotrexate for abortion. Contraception. 1999;59:11–16.
   PubMed Web of Science ®Google Scholar
• Yilmaz B, Kelekci S, Ertas IE, et al. Misoprostol moistened with acetic acid or saline for second trimester pregnancy termination: a randomized prospective double-blind trial. Hum Reprod. 2005;20:3067–3071.
   PubMed Web of Science ®Google Scholar
• Abd-El-Maeboud KH, Ghazy A, Ibrahim A, et al. Vaginal acidity enhancement with a 3% acetic acid gel prior to misoprostol treatment for pregnancy termination in the midtrimester. Int J Gynaecol Obstet. 2012;119:248–252.
   PubMed Web of Science ®Google Scholar
• Wijesinghe PS, Padumadasa GS, Palihawadana TS, et al. A trial of expectant management in incomplete miscarriage. Ceylon Med J. 2011;56:10–13.
   PubMedGoogle Scholar
• Dangalla DPR, Goonewardene IMR. Surgical treatment versus expectant care in the management of incomplete miscarriage: a randomised controlled trial. Ceylon Med J. 2012;57:140–145.
   PubMedGoogle Scholar
• Nadarajah R, Quek YS, Kuppannan K, et al. A randomised controlled trial of expectant management versus surgical evacuation of early pregnancy loss. Eur J Obstet Gynecol Reprod Biol. 2014;178:35–41.
   PubMed Web of Science ®Google Scholar
• Al-Ma’ani W, Solomayer EF, Hammadeh M. Expectant versus surgical management of first-trimester miscarriage: a randomised controlled study. Arch Gynecol Obstet. 2014;289:1011–1015.
   PubMed Web of Science ®Google Scholar
• Savaris RF, de Moraes GS, Cristovam RA, et al. Are antibiotics necessary after 48 hours of improvement in infected/septic abortions? A randomized controlled trial followed by a cohort study. Am J Obstet Gynecol. 2011;204:301.e1–305.
   Web of Science ®Google Scholar
• Brazil Ministry of Health. Labour induction. In: Delivery, abortion and puerperium: humanized assistance to women [in Portuguese]. Brasília: Ministry of Health 2001.
   Google Scholar
• Altman DG, Bland JM. Statistics notes: how to randomise. BMJ. 1999;319:703–704.
   PubMed Web of Science ®Google Scholar
• Tang OS, Schweer H, Seyberth HW, et al. Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod. 2002;17:332–336.
   PubMed Web of Science ®Google Scholar
• Ngai SW, Tang OS, Chan YM, et al. Vaginal misoprostol alone for medical abortion up to 9 weeks of gestation: efficacy and acceptability. Hum Reprod. 2000;15:1159–1162.
   PubMed Web of Science ®Google Scholar
• Berard V, Fiala C, Cameron S, et al. Instability of misoprostol tablets stored outside the blister: a potential serious concern for clinical outcome in medical abortion. PLoS One. 2014;9:e112401.
   PubMed Web of Science ®Google Scholar
• Lee VCY, Yung SSF, Li RHW, et al. A randomized comparison of pharmacokinetics of a single vaginal dose of dry misoprostol or misoprostol moistened with normal saline or with acetic acid. Hum Reprod. 2011;26:2981–2987.
   PubMed Web of Science ®Google Scholar
• Abd-El-Maeboud KH, Ghazy AA, Nadeem AA, et al. Effect of vaginal pH on the efficacy of vaginal misoprostol for induction of midtrimester abortion. J Obstet Gynaecol Res. 2008;34:78–84.
   PubMed Web of Science ®Google Scholar
• Radulovic N, Norström A, Ekerhovd E. Outpatient cervical ripening before first-trimester surgical abortion: a comparison between misoprostol and isosorbide mononitrate. Acta Obstet Gynecol Scand. 2007;86:344–348.
   PubMed Web of Science ®Google Scholar
• Austin PC, Brunner LJ. Inflation of the type I error rate when a continuous confounding variable is categorized in logistic regression analyses. Statist Med. 2004;23:1159–1178.
   PubMed Web of Science ®Google Scholar