Sublingual misoprostol before insertion of levonorgestrel-releasing intrauterine contraceptive device in lactating women following cesarean section | ||||
| The Egyptian Journal of Fertility and Sterility | ||||
| Volume 27, Issue 1 - Serial Number 11106352, January 2023, Page 70-76 PDF (2.72 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2023.286064 | ||||
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| Authors | ||||
Hany Saad  ; Hadeer Mashaal; Mohamed Elfakhrany
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| Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. | ||||
| Abstract | ||||
| Background: Misoprostol is used for cervical softening before minimally invasive gynecological procedures. We aimed to assess the benefits and drawbacks of using sub-lingual misoprostol before inserting the levonorgestrel-re-leasing intrauterine contraceptive device (LNG-IUCD) in women who have never had a vaginal birth. Methods: A clinical trial was conducted on 72 recruited women with lactational amenorrhea with no previous vag-inal delivery. They were equally divided into 2 groups; group 1 received sublingual misoprostol 400 mcg 2 hours before Mirena insertion, and group 2 received a placebo 2 hours before the procedure. Results: We observed easy insertion of Mirena IUCD in women of the misoprostol group, but with no significant difference between both groups. However, the duration of IUCD insertion was significantly shorter in the misoprostol group compared to the placebo group (5.03 ± 0.74 vs. 5.58 ± 0.94 minutes, P=0.007). The VAS pain score was signifi-cantly decreased in the misoprostol group (3.33 ± 1.29 vs. 3.97 ± 1.28, P=0.038) with a higher patient satisfaction score (7.22 ± 1.38 vs. 6.28 ± 1.41, P=0.005). Regarding the side effects, women in the misoprostol group experienced more nausea/vomiting, slight hyperthermia, and uterine cramps (P= 0.018, 0.011, and 0.173, respectively). Conclusion: Sublingual administration of misoprostol be-fore Mirena IUCD insertion could help increase the ease of insertion with a significant decrease in the procedure time. Furthermore, it could improve patient satisfaction and de-crease the pain experience. | ||||
| Keywords | ||||
| Sublingual misoprostol; Levonorgestrel-releas-ing IUCD; Mirena | ||||
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