Cochrane · systematic review · CD005998
Preoperative ripening of the cervix before operative hysteroscopy
Al‐Fozan, H, Firwana, B, Al Kadri, H, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 7 · 58.3%Moderate 5 · 41.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Misoprostol compared to placebo or no treatment before operative hysteroscopy
Population: Pre and post menopausal women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ease of dilatation: need for mechanical dilatation Misoprostol vs placebo or no treatment before operative hysteroscopy | OR 0.08 [0.04, 0.16] | 5 studies · 441 participants | Moderate |
Intraoperative complications Misoprostol vs placebo or no treatment before operative hysteroscopy | OR 0.37 [0.18, 0.77] | 12 studies · 901 participants | Moderate |
Specific intraoperative complications ‐ Cervical laceration/tear Misoprostol vs placebo or no treatment before operative hysteroscopy | OR 0.25 [0.11, 0.57] | 9 studies · 669 participants | Moderate |
Specific intraoperative complications ‐ False track Misoprostol vs placebo or no treatment before operative hysteroscopy | OR 0.34 [0.12, 0.97] | 7 studies · 560 participants | Moderate |
Specific intraoperative complications ‐ Uterine perforation Misoprostol vs placebo or no treatment before operative hysteroscopy | OR 0.42 [0.13, 1.38] | 7 studies · 455 participants | Low |
Specific intraoperative complications ‐ Uterine bleeding Misoprostol vs placebo or no treatment before operative hysteroscopy | OR 0.51 [0.1, 2.49] | 4 studies · 340 participants | Low |
Side effects Misoprostol vs placebo or no treatment before operative hysteroscopy | OR 2.59 [1.15, 5.79] | 4 studies · 272 participants | Moderate |
Misoprostol compared to dinoprostone before operative hysteroscopy
Population: Pre and post menopausal women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ease of dilatation: need for mechanical dilatation Misoprostol vs dinoprostone before operative hysteroscopy | OR 0.58 [0.34, 0.98] | 1 study · 310 participants | Low Downgraded: risk of bias |
Intraoperative complications Misoprostol vs dinoprostone before operative hysteroscopy | OR 0.32 [0.12, 0.83] | 1 study · 310 participants | Low Downgraded: risk of bias |
Side effects Misoprostol vs dinoprostone before operative hysteroscopy | no estimate extracted | NR | Low Downgraded: risk of bias |
Misoprostol compared to osmotic dilator before operative hysteroscopy
Population: Pre and post menopausal women
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Ease of dilatation: need for mechanical dilatation Misoprostol vs osmotic dilator before operative hysteroscopy | OR 5.96 [2.61, 13.59] | 1 study · 110 participants | Low Downgraded: risk of bias |
Intraoperative complications Misoprostol vs osmotic dilator before operative hysteroscopy | OR 5.14 [0.24, 109.01] | 3 studies · 354 participants | Low Downgraded: risk of bias, imprecision |