Evaluating the efficacy of vaginal misoprostol as a pre-insertion adjunct for intrauterine contraceptive device placement in women with a history of previous cesarean deliveries

Abstract

Double blinded randomized controlled clinical trial carried out in gynecological and obstetric department in Tikrit Teaching Hospital from 1st October 2023 to 28th July 2024. A sample of 100 women candidates for intrauterine device insertion was enrolled in the study; divided randomly into 2 groups; group A (50 women) received 400 microgram of misoprostol vaginally 3 hours before intrauterine device insertion and group B (50 women) as a control group. Most of the cases and control group had ≥2 caesarian section (c/s) 26(52%), 32(64%) respectively. In most of the cases group and control group the uterine position was anteverted uterus (AVU), 48(96%), 49(98%) respectively, while retroverted uterus (RVU) found among 2(4%) of the cases and 1(2%) of the controls, this relation was statistically not significant, Failed insertion significantly lower among cases 1(2%) than controls 2(4%), the easy insertion was significantly higher among cases 35 (70%) than controls 23(46%), while difficult insertion was significantly lower among cases 14(28%) than controls 25(50%). The mean visual analogue scale (VAS) scores of cases group (3.4±0.7) was significantly lower than control group (5.3±0.8). The mean patient satisfaction score of cases group (9.1±0.5) was significantly higher than control group (7.8±0.6). Non-significant difference in analgesia needed among cases group 6(12%) and control group 13(26%) of the. The commonest side effect reported among cases was abdominal cramping 10(20%), was significantly higher than control group 3(6%), followed by diarrhea 7(14%), 0(0%) respectively, and nausea 7(14%), 1(2%) respectively.