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ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 3  |  Page : 661-667

Vaginal or sublingual misoprostol before insertion of an intrauterine device in women who have previously had a cesarean section


Department of Obstetrics and Gynecology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt

Correspondence Address:
MD Hanan A.E.M Mohammed
Omar Zaafan St Number 13 flat 602, Nasr City, First District, Cairo, 11765
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjamf.sjamf_79_19

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Background A cesarean section is an operation to deliver a baby. It involves making a cut in the front wall of a woman’s tummy (abdomen) and womb. It makes the procedure of labor easier and safer. Objective the aim was to investigate whether vaginal or sublingual misoprostol facilitates insertion of an intrauterine device (IUD) in women who have previously had a cesarean section. Patients and methods This was a randomized clinical study. The study was conducted at Mit Ghammer Maternity Hospital from March 2015 to January 2017. Regarding population of the study, 200 women candidates for TCu-380A IUD insertion were enrolled in the study. Half of them received 400 µg of misoprostol tablets vaginally and the others received sublingually 400 µg of misoprostol tablets. Results In the present study, 200 women with previous caesarean section and no prior vaginal delivery were included. They were divided into two groups: 100 women received 400 µg of misoprostol vaginally 4 h before IUD insertion, and 100 women received 400 µg of misoprostol sublingually 4 h before IUD insertion. There was no statistically significant difference between both groups regarding age, parity, and number of previous cesarean section deliveries. There was no statistically significant difference between both groups regarding menstrual changes after IUD insertion (first menstruation). Conclusion Vaginal or sublingual 400 µg of misoprostol administrated 4 h before IUD insertion facilitates IUD insertion and reduces the incidence of pain during the procedure. Vaginal misoprostol is preferred than sublingual route as cervical ripening occurs more likely with vaginal administration.


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