Vaginal versus sublingual misoprostol administration before intrauterine device insertion in women with previous failed trial

Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Menoufia, Egypt

2 Family planning clinic at El Hawamdia primary health care, Giza

Abstract

Background: Intrauterine device (IUD) is one of the most efficient contraceptive techniques, despite its low use rate due to the user's fear of discomfort and the pro-vider's insertion issues. Misoprostol is a drug that softens and facilitates dilatation of the cervix.   
Objectives: The aim of the current work was to com-pare the efficacy of using misoprostol (Vaginally versus sublingually) before IUD insertion in cases of previously failed trial.   
Patients and methods: A prospective interventional comparative study included 80 women who had history of failed previous IUD insertion, attending at Outpatient Clinics, Menoufia university and El Hawamdia prima-ry health care, from April 2022 till August 2023 .There were randomly divided into Group A which included 40 women who used misoprostol vaginally, 2-4 hours before IUD insertion and group B included 40 women who used misoprostol sublingually 2-4 hours before IUD insertion. Success of IUD insertion, participant pain and satisfac-tion were compared between the two groups. 
Results: There was statistically significant difference be-tween vaginal misoprostol group and sublingual group regarding IUD insertion with a P value of 0.034. There was also highly significant difference in the occurrence of pain with a P value of 0.001 according to visual analog scale and numeric rating scale.
Conclusion: usage of Vaginal misoprostol (400 µg) 2-4 h before IUD insertion increase the rate of IUD and reduces the incidence of pain during the procedure. 

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