Effectiveness of Different Routes of Misoprostol Administration for Cervical Ripening before Uterine Cavity Operation:A Meta-analysis

WANG Jun; E Qi-min; XIAO Chao

Abstract：Objective:To assess the efficacy and side effects of different routes of misoprostol administration for cervical ripening before uterine cavity operation. Methods:The databases of Medline,Embase,the Cochrane Library,CNKI,CBM, Wanfang Data were retrieved to October 2014. According to the inclusion and exclusion criteria ,literature was screened and extracted by two researchers independently ,and then the quality was reviewed by and treated by using Rev Man 5.2 software. Results:12 studies with 2 529 participants were included. Evidence was found that there were no statistical differences in cervical diameter,when misoprostol administered orally or sublingually or vaginally were compared in pairs (P>0.05). Uterine cavity operation time in vaginally administered was less than in the orally (P<0.05), but there was no significant difference in cervical dilatation time (P>0.05). And the above two index in sublingually administerd were less than in vaginally (P<0.05). The incidence of nausea and diarrhea were found to be more common in the orally and sublingually administered misoprostol group compared with vaginally administered,and emesis was found to be more common in sublingually administered misoprostol group when comparing with vaginally administered misoprostol group(P<0.05). In addition,different routes of misoprostol administration were no statistical differences in incidence of side effects including cramping,vaginal bleeding,fever and shivering (P>0.05). Conclusions:Misoprostol administered orally or sublingually had similar efficacy in cervical ripening of vaginal misoprostol. In view of avoiding drug related side effects,vaginally route of misoprostol could be considered as an effective medication.