Abstract
Objective
The current study aims to evaluate if vaginal misoprostol (400 mcg) administered prior
to intrauterine device (IUD) insertion increases the ease and success of insertion
among women who had delivered only by elective cesarean delivery (CD).
Study design
The current study was a randomized, double-blind, placebo-controlled trial conducted
in Assiut Women's Health Hospital, Egypt, between the 1st of April 2015 and the 31st
of March 2016 and included women who delivered only by elective CD. One hundred forty
women were randomized into two groups; misoprostol group received two misoprostol
400-mcg tablets vaginally, and placebo group received two placebo tablets 3 h before
a copper T380A IUD insertion. The primary outcome measure was the difference in the
ease of insertion score using a 10-cm visual analog scale between both groups with
0 = very easy insertion, and 10 = terribly difficult insertion.
Results
The ease of insertion score was lower in the misoprostol group (2.2±0.5 vs. 4.2±0.5,
p=.0001) with higher number of successful IUD insertions than the placebo group (69
[98.6%] vs. 61 [87.1%], p=.009). The mean pain score reported by the women was lower
in misoprostol group (2.7±0.6 vs. 4.3±0.8) with higher level of satisfaction from
the whole procedure (8.9±0.4 vs. 7.9±0.2) with p=.001 for both.
Conclusions
Misoprostol 400 mcg vaginally prior to IUD insertion eases and increase the success
of insertion with reduction of pain among women who had delivered only by elective
CD.
Implications
The use of vaginal misoprostol before IUD insertion in women who had never delivered
vaginally before may increase the ease and success of insertion. Moreover, it may
reduce the pain felt by women during the procedure.
Keywords
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Article info
Publication history
Published online: January 13, 2017
Accepted:
January 4,
2017
Received in revised form:
January 2,
2017
Received:
May 31,
2016
Footnotes
☆Trial registration: Clinicaltrials.gov NCT02412033.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
