Fatemeh Hosseinzadeh - Reproductive Health Research Center, Department of Obstetrics & Gynecology, Alzahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Mandana Mansour Ghanaie - Reproductive Health Research Center, Department of Obstetrics & Gynecology, Alzahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Roya Faraji - Reproductive Health Research center, Guilan University of Medical Sciences, Rasht, Iran
Ghazaleh Ghorbani - Reproductive Health Research Center, Department of Obstetrics & Gynecology, Alzahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
Seyedeh Maryam Asgari Galebin - Guilan University of Medical Sciences, Rasht, Iran
Sedigheh Pakseresht - Department of Obstetrics, Community Health, Women Health Promotion, Social Determinants of Health Research Center, Reproductive Health Research Center, Shahid Beheshti Nursing and Midwifery School, Guilan University of Medical Sciences, Rasht, Iran
Saman Maroufizadeh - Department of Biostatistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
Seyed Mohammad Asgari Galebin - Guilan University of Medical Sciences, Rasht, Iran

Introduction: Termination of pregnancy through curettage in the first trimester requires cervical ripening (CR) which can be induced by medicinal or mechanical methods. In the pharmaceutical method, vaginal administration of misoprostol, as well as vaginal trinitroglycerin (TNG), has been shown to induce effective CR. This study was conducted with the aim of comparing vaginal misoprostol and vaginal TNG in the CR of women candidates for the first-trimester curettage.Materials and Methods: This double-blind clinical trial study was conducted on ۱۶۸ pregnant women with a gestational age of less than ۱۴ weeks who were candidates for curettage. Participants were randomly divided into two groups receiving vaginally either TNG (۴۰۰ µgr)(n=۸۷) or misoprostol (۴۰۰ µgr) (n=۸۱). Then, the state of CR and the need for mechanical dilatation were compared between the two groups. Also, the presence of any side effects caused by drug use was determined.Results: The percentage of CR in the misoprostol group (۶۷.۹%) was significantly higher than in the TNG group (۳۲.۲%) (P<۰.۰۰۱). Therefore, the need for mechanical dilatation in the TNG group (۶۶.۷%) was significantly higher compared with the misoprostol group (۳۲.۱%) (P<۰.۰۰۱). Also, the rate of complications like diarrhea (۹.۹%) and abdominal pain (۷.۴%) in the misoprostol group was significantly higher than in the TNG group (۰%). However, headache in the TNG group (۳۴.۵%) was significantly higher than in the misoprostol group (۰%) (P>۰.۰۰۱). Generally, the rate of complications in the TNG group (۳۵.۶%) was significantly higher compared with the misoprostol group (۱۳.۶%) (P>۰.۰۰۱).Conclusion: Vaginally Misoprostol is more effective than vaginally TNG on CR of first-trimester curettage as well as it significantly reduces the need for mechanical dilatation of the cervix.Introduction: Termination of pregnancy through curettage in the first trimester requires cervical ripening (CR) which can be induced by medicinal or mechanical methods. In the pharmaceutical method, vaginal administration of misoprostol, as well as vaginal trinitroglycerin (TNG), has been shown to induce effective CR. This study was conducted with the aim of comparing vaginal misoprostol and vaginal TNG in the CR of women candidates for the first-trimester curettage. Materials and Methods: This double-blind clinical trial study was conducted on ۱۶۸ pregnant women with a gestational age of less than ۱۴ weeks who were candidates for curettage. Participants were randomly divided into two groups receiving vaginally either TNG (۴۰۰ µgr)(n=۸۷) or misoprostol (۴۰۰ µgr) (n=۸۱). Then, the state of CR and the need for mechanical dilatation were compared between the two groups. Also, the presence of any side effects caused by drug use was determined. Results: The percentage of CR in the misoprostol group (۶۷.۹%) was significantly higher than in the TNG group (۳۲.۲%) (P<۰.۰۰۱). Therefore, the need for mechanical dilatation in the TNG group (۶۶.۷%) was significantly higher compared with the misoprostol group (۳۲.۱%) (P<۰.۰۰۱). Also, the rate of complications like diarrhea (۹.۹%) and abdominal pain (۷.۴%) in the misoprostol group was significantly higher than in the TNG group (۰%). However, headache in the TNG group (۳۴.۵%) was significantly higher than in the misoprostol group (۰%) (P>۰.۰۰۱). Generally, the rate of complications in the TNG group (۳۵.۶%) was significantly higher compared with the misoprostol group (۱۳.۶%) (P>۰.۰۰۱). Conclusion: Vaginally Misoprostol is more effective than vaginally TNG on CR of first-trimester curettage as well as it significantly reduces the need for mechanical dilatation of the cervix.

Misoprostol, Trinitroglycerin, Cervical ripening