More Harm Than Good: The Lack of Evidence for Administering Misoprostol Prior to IUD Insertion

Waddington, Ashley; Reid, Robert L.

doi:10.1016/s1701-2163(16)35465-2

Cited by 10 publications

(3 citation statements)

References 10 publications

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“…Waddington & Reid recommended against the routine use of misoprostol for IUD insertion. Their review demonstrated consistent findings that misoprostol administration does not improve the ease of insertion of IUDs and leads to increased unpleasant side effects 47 . Sublingual 200 μg misoprostol has no role in pain reduction or increase the ease of IUD insertion in women with a tight cervix or in whom vaginal delivery was not experienced 48 …”

Section: Discussionmentioning

confidence: 95%

“…Their review demonstrated consistent findings that misoprostol administration does not improve the ease of insertion of IUDs and leads to increased unpleasant side effects. 47 Sublingual 200 μg misoprostol has no role in pain reduction or increase the ease of IUD insertion in women with a tight cervix or in whom vaginal delivery was not experienced. 48 A recent meta-analysis by Tassi et al 49 demonstrated that misoprostol had a heterogeneous pattern of efficacy with increased side effects.…”

Section: Discussionmentioning

confidence: 99%

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Comparative efficacy of lidocaine–prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

Hashem

Mahmoud

Islam

et al. 2022

Intl J Gynecology & Obste

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ObjectiveTo compare efficacy of lidocaine–prilocaine (LP) cream versus misoprostol versus placebo before levonorgestrel‐releasing intrauterine device (LNG‐IUD) insertion.MethodsThis randomized controlled trial (RCT) was conducted in a tertiary referral hospital from April 30, 2020 to March 1, 2021 on 210 parous women willing to receive LNG‐IUD and delivered only by elective cesarean delivery (CD). Participants received 200 μg vaginal misoprostol or 5 ml of LP cream 5% or placebo 3 h before LNG‐IUS insertion. Primary outcome was pain during LNG‐IUD insertion, while secondary outcomes were pain 10 min post‐procedure, ease of insertion, patient satisfaction, insertion time, and drug side effects.ResultsPain during LNG‐IUS insertion was reduced in LP group and misoprostol group compared to placebo group (2.1 ± 1.0 vs 3.7 ± 1.6; p <0.001) and (2.3 ± 1.3 vs 3.7 ± 1.6; p <0.001), respectively. Ease of procedure and patient satisfaction were significantly higher in LP and misoprostol groups than placebo (P <0.001). Need for additional analgesia was significantly higher in placebo group than in the other two groups (P = 0.009). Adverse events were not significantly different between the three groups except vomiting and abdominal cramps, which were higher with misoprostol.ConclusionLP cream and 200 μg of vaginal misoprostol administration before LNG‐IUD insertion in women delivered only by elective CD effectively reduced pain during insertion and 10 min post‐procedure with easier insertions, high patient satisfaction, and tolerable side effects. Pain reduction with LP cream was clinically significant.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Comparative efficacy of lidocaine–prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

Hashem

Mahmoud

Islam

et al. 2022

Intl J Gynecology & Obste

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“…Bien que, dans certains cas tri es sur le volet, l'administration pr ealable de misoprostol par voie orale ou vaginale puisse faciliter l'insertion du CIU, elle est associ ee a des scores accrus de douleur au cours de la p eriode suivant imm ediatement l'insertion et a divers autres effets ind esirables (comme des saignements,des douleurs / crampes abdominales et de la fi evre) 155,159 . Ainsi, l'utilisation syst ematique de misoprostol dans le cadre de l'insertion d'un CIU devraitêtre d econseill ee 160 .…”

Section: Les Ciu Ne Sont Pas Des Contraceptifs Efficacesunclassified

Consensus canadien sur la contraception (partie 3 de 4): chapitre 7 - Contraception intra-utérine

Guilbert¹

2019

Journal of Obstetrics and Gynaecology Canada

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La qualit e des r esultats signal es dans les pr esentes directives cliniques a et e etablie conform ement aux crit eres d' evaluation des r esultats pr esent es dans le Rapport du Groupe d' etude canadien sur les soins de sant e pr eventifs. y Les recommandations que comprennent les pr esentes directives cliniques ont et e class ees conform ement a la m ethode de classification d ecrite dans le Rapport du Groupe d' etude canadien sur les soins de sant e pr eventifs.

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Interventions for pain with intrauterine device insertion

Lopez

Bernholc

Zeng

et al. 2015

Cochrane Database of Systematic Reviews

108

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More Harm Than Good: The Lack of Evidence for Administering Misoprostol Prior to IUD Insertion

Cited by 10 publications

References 10 publications

Comparative efficacy of lidocaine–prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

Comparative efficacy of lidocaine–prilocaine cream and vaginal misoprostol in reducing pain during levonorgestrel intrauterine device insertion in women delivered only by cesarean delivery: A randomized controlled trial

Consensus canadien sur la contraception (partie 3 de 4): chapitre 7 - Contraception intra-utérine

Interventions for pain with intrauterine device insertion

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