Published date:Jun 10 2019

Journal Title: International Journal of Reproductive BioMedicine

Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 17, Issue No. 4

Pages:253 - 260

DOI: 10.18502/ijrm.v17i4.4550

Shiva HadadianpourPreventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Shahrzad TavanaShahrzad.Tavana@utexas.eduUniversity of Texas South West (UTSW), Dallas, Texas, USA.

Anahita TavanaUniversity of Texas Medical Branch (UTMB), Texas, USA.

Masoumeh FallahianPreventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Cervical dilation is indicated prior to performing various gynecological procedures. However, gynecologists are at times confronted with a stenotic or tight cervix, resistant to dilation. This can be problematic particularly when cervical ripening has not been attempted hours before the start of the procedure.

Objective: The objective of this study is to investigate the efficacy of administration of hyoscine butylbromide for cervical dilation for immediate dilation of the tight or stenotic cervix.

Materials and Methods: In this clinical trial study, a population of 40 women, aged 20-70 yr with stenotic cervix, evidenced by resistance to pass dilator #2 through their cervical canal were compared. Cervical patency was assessed 10 min following intracervical canal instillation of hyoscine butylbromide.

Results: Cervical width of 57.5% of patients became wider, as evidenced by passage of the number 4 Hegar dilator through the cervical canal without resistance. Independent T-tests did not reveal any statistically significant difference between the two groups based on their age. Fisher Exact test revealed a statistically significant difference between the two groups based on the prior route of delivery, with a more statistically significant response in patients who had vaginal deliveries.

Conclusion: Intra-cervical canal instillation of hyoscine butylbromide is effective in immediate dilation of the tight or stenotic cervix during intra-uterine procedures.

[1] Gelber S, Sciscione A. Mechanical methods of cervical ripening and labor induction. Clin Obstet Gynecol 2006;
49: 642–657.

[2] Bradley LD. Complications in hysteroscopy: prevention, treatment, and legal risk. Curr Opin Obstet Gynecol 2002;14: 409–415.

[3] Mohammadian S, Tavana A, Tavana S, Mohammadian A, Fallahian M. Cervical priming by misoprostol before
diagnostic dilatation and curettage: A randomized clinical trial. J Reprod Infertil 2015; 16: 162–166.

[4] Timmons B, Akins M, Mahendroo M. Cervical remodeling during pregnancy and parturition. Trends Endocrinol Metab 2010; 21: 353–361.

[5] Sirohiwal D, Dahiya K, De M. Efficacy of hyoscine-Nbutyl bromide (Buscopan) suppositories as a cervical
spasmolytic agent in labour. Aust NZ J Obstet Gynaecol 2005; 45: 128–129.

[6] Hadadian S, Fallahian M. Assessing the efficacy of vaginal hyoscine butyl bromide on cervical ripening prior to
intrauterine procedures: A double-blinded clinical trial. Int J Reprod Biomed 2016; 14: 709–712.

[7] Samuels LA, Christie L, Roberts-Gittens B, Fletcher H, Frederick J. The effect of hyoscine butylbromide on the
first stage of labour in term pregnancies. BJOG 2007; 114: 1542–1546.

[8] Hotwani J, Ainapure SS. Hyoscine Butylbromide suppositories. Indian Med Gaz 2000; 217–219.

[9] Qahtani NH, Hajeri FA. The effect of hyoscine butylbromide in shortening the first stage of labor: a double blind,randomized, controlled, clinical trial. Ther Clin Risk Manag2011; 7: 495–500.