Preoperative ripening of the cervix before operative hysteroscopy

Abstract

Hysteroscopy is a common gynaecological procedure carried out for both diagnostic and surgical treatments for conditions within the uterus. Hysteroscopy is reported to be a safe surgical intervention, but complications such as cervical tears, formation of false passages, bleeding and uterine perforation may occur. Evidence suggests that these complications can often be mitigated by preoperative ripening of the cervix prior to insertion of the hysteroscope into the uterine cavity via the cervical entry. This review examined whether there are benefits to cervical ripening and evaluated the effectiveness and safety of any available preoperative agent, synthetic or naturally occurring, compared with each other, placebo or no treatment. Knowledge of this surgical preparation will aid the nurse to support and educate women about preoperative medications used to achieve cervical ripening.