Novelty in Biomedicine

Vol. 14 No. 1 (2026)

Effects of Using Misoprostol for Cervical Ripening in Molar Pregnancy: A Double-blinded, Randomized Controlled Trial Study

Novelty in Biomedicine, Vol. 14 No. 1 (2026), 8 February 2026 , Page 13-20
https://doi.org/10.22037/nbm.v14i1.48925

Abstract

Background: Molar pregnancy is a rare and benign disease. If a molar pregnancy is diagnosed, treatment should be given immediately. Misoprostol is a synthetic prostaglandin analog commonly used for cervical ripening. This study was performed to determine the effects of misoprostol on cervical ripening in molar pregnancy.

Materials and Methods: This double-blind, randomized clinical trial was performed on 150 pregnant women candidates for the termination of a molar pregnancy. Patients were divided into two intervention groups, receiving vaginal misoprostol at a dose of 400 μg four hours before suction-curettage, and the control group, treated by suction-curettage and using a vaginal placebo. Information, including age, education, history of abortion, curettage, molar pregnancy, time of last menstruation, gestational age, and consequences of misoprostol use, and bleeding during and after curettage, was included in a questionnaire. Data were analyzed using Stata ver 13MP using descriptive statistics, t-tests, chi-square tests, and Bonferroni post hoc tests. A P value < 0.05 was considered significant.

Results: The study included 150 patients with an average age of 28 years. There was a significant association between the misoprostol group as an intervention and variables including age (p=0.003), gravidity (p<0.001), parity (p=0.011), delivery type (p=0.021), dilators (p<0.001), duration of surgery (p<0.001), and decreases in hemoglobin after curettage (p<0.001).

Conclusion: Our study indicated that vaginal administration of misoprostol was a simple and effective treatment for terminating molar pregnancy and seemed to have significant advantages over the current methods.

Keywords:
  • Molar pregnancy
  • Misoprostol
  • Cervix
  • Clinical trial

How to Cite

Mirzamoradi, M., Ashrafganjoei, T., Heidar, Z., Parsa, T., Bakhtiyari, M., & Parsa, Y. (2026). Effects of Using Misoprostol for Cervical Ripening in Molar Pregnancy: A Double-blinded, Randomized Controlled Trial Study. Novelty in Biomedicine, 14(1), 13–20. https://doi.org/10.22037/nbm.v14i1.48925

References

1. Kimiaee P, Ashrafi-vand S, Mansournia MA, Bakhtiyari M, Mirzamoradi M, Bakhtiyari Z. Predictive values of different forms of human chorionic gonadotropin in postmolar gestational trophoblastic neoplasia. International Journal of Gynecologic Cancer. 2014;24(9).

2. Seckl MJ, Sebire NJ, Berkowitz RS. Gestational trophoblastic disease. The Lancet. 2010;376(9742):717-29.

3. Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Munson ML. Births: final data for 2002. National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2003;52(10):1-113.

4. Dodd JM, Crowther CA, Robinson JS. Oral misoprostol for induction of labour at term: randomised controlled trial. BMJ (Clinical research ed). 2006;332(7540):509-13.

5. Cunningham FG. Williams obstetrics2014.

6. Braga A, Mora P, de Melo AC, Nogueira-Rodrigues A, Amim-Junior J, Rezende-Filho J, et al. Challenges in the diagnosis and treatment of gestational trophoblastic neoplasia worldwide. World journal of clinical oncology. 2019;10(2):28-37.

7. Fernandez H, Alby JD, Tournoux C, Chauveaud-Lambling A, DeTayrac R, Frydman R, et al. Vaginal misoprostol for cervical ripening before operative hysteroscopy in pre-menopausal women: a double-blind, placebo-controlled trial with three dose regimens. Human reproduction (Oxford, England). 2004;19(7):1618-21.

8. Henrich W, Dudenhausen JW, Hanel C, Chen FC. [Oral misoprostol against vaginal dinoprostone for labor induction at term: a randomized comparison]. Zeitschrift fur Geburtshilfe und Neonatologie. 2008;212(5):183-8.

9. Abbassi RM, Sirichand P, Rizvi S. Safety and efficacy of oral versus vaginal misoprostol use for induction of labour at term. Journal of the College of Physicians and Surgeons--Pakistan: JCPSP. 2008;18(10):625-9.

10. Ozkan S, Calişkan E, Doğer E, Yücesoy I, Ozeren S, Vural B. Comparative efficacy and safety of vaginal misoprostol versus dinoprostone vaginal insert in labor induction at term: a randomized trial. Archives of gynecology and obstetrics. 2009;280(1):19-24.

11. Ferraz TJ, Bartosch CM, Ramalho CM, Carvalho FA, Carvalho BC, Brandão OG, et al. Complete mole in a dichorionic twin pregnancy after intracytoplasmic sperm injection. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia. 2013;35(1):39-43.

12. Wing DA, Ham D, Paul RH. A comparison of orally administered misoprostol with vaginally administered misoprostol for cervical ripening and labor induction. American journal of obstetrics and gynecology. 1999;180(5):1155-60.

13. Crane JM, Healey S. Use of misoprostol before hysteroscopy: a systematic review. Journal of obstetrics and gynecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC. 2006;28(5):373-9.

14. Berkowitz RS, Goldstein DP. Clinical practice. Molar pregnancy. The New England journal of medicine. 2009;360(16):1639-45.

15. Tidy JA, Gillespie AM, Bright N, Radstone CR, Coleman RE, Hancock BW. Gestational trophoblastic disease: a study of mode of evacuation and subsequent need for treatment with chemotherapy. Gynecologic oncology. 2000;78(3 Pt 1):309-12.

16. Flam F, Lundström V, Pettersson F. Medical induction prior to surgical evacuation of hydatidiform mole: is there a greater risk of persistent trophoblastic disease? European journal of obstetrics, gynecology, and reproductive biology. 1991;42(1):57-60.

17. Niemann I, Vejerslev LO, Frøding L, Blaakær J, Maroun LL, Hansen ES, et al. Gestational trophoblastic diseases - clinical guidelines for diagnosis, treatment, follow-up, and counseling. Danish medical journal. 2015;62(11):A5082.

18. Tidy JA, Hancock BW, Newlands ES. The Management of Gestational Trophoblastic Disease. Clinical guideline 38. London: Royal College of Obstetricians and Gynaecologists, 2010.

19. Palmer JR. Advances in the epidemiology of gestational trophoblastic disease. The Journal of reproductive medicine. 1994;39(3):155-62.

20. Ngan S, Seckl MJ. Gestational trophoblastic neoplasia management: an update. Current opinion in oncology. 2007;19(5):486-91.

21. Hou JL, Wan XR, Xiang Y, Qi QW, Yang XY. Changes of clinical features in hydatidiform mole: analysis of 113 cases. The Journal of reproductive medicine. 2008;53(8):629-33.

22. Seckl MJ, Gillmore R, Foskett M, Sebire NJ, Rees H, Newlands ES. Routine terminations of pregnancy--should we screen for gestational trophoblastic neoplasia? Lancet (London, England). 2004;364(9435):705-7.

23. Biscaro A, Braga A, Berkowitz RS. Diagnosis, classification and treatment of gestational trophoblastic neoplasia. Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):42-51.

24. Seckl M, Sebire N, Fisher R, Golfier F, Massuger L, Sessa C, et al. Gestational trophoblastic disease: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Annals of oncology. 2013;24(suppl_6):vi39-vi50.

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