Correspondence:Waleed Ali Sayed Ahmed, Lecturer, Department of Obstetrics and Gynaecology, Faculty of Medicine, Suez Canal University, Round Road, Ismailia 41111, Egypt. Tel: + 201091214406 (Mobile); + 2663334230 (Landline). Fax: + 2 (064)3227426. E-mail: waleed.asa@gmail.com The European Journal of Contraception and Reproductive Health Care, 2013; Early Online: 1–9 Sublingual misoprostol prior to insertion of a T380A intrauterine device in women with no previous vaginal delivery Zakia Mahdy Ibrahim and Waleed Ali Sayed Ahmed Department of Obstetrics and Gynaecology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ABSTRACT Objective To investigate whether sublingual misoprostol administered one hour before intrauterine device (IUD) insertion reduces failed insertions, insertion-related complications and pain in parous women delivered only by elective caesarean section (CS). Methods Single-blind randomised controlled trial conducted in Ismailia, Egypt, between July 2010 and December 2011. Women who had never delivered otherwise than by elective CS and desirous of using an IUD were randomly allocated to receive sublingually 400 μg misoprostol and 100 mg diclofenac (misoprostol group) or 100 mg diclofenac alone (control group) one hour before IUD insertion. Outcome measures were failed insertion, ease of insertion judged by the investigators, insertion-related complications, and patients’ satisfaction. Results In all, 255 women (130 and 125 in the study and control groups, respectively) had an IUD inserted. Seven insertions failed: five in the control group, and two in the study group. Ease of insertion and patients’ satisfaction were comparable in both groups. Abdominal pain and nausea were the commonest side effects reported in the misoprostol group. Conclusion Sublingual administration of misoprostol one hour before IUD insertion in parous women with no previous vaginal delivery does not facilitate the procedure and may cause undesirable side effects. This approach is not recommended as a standard treatment. KEYWORDS Misoprostol, Intrauterine device, Insertion of intrauterine device, Pain, Cervical priming, Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . © 2013 The European Society of Contraception and Reproductive Health DOI: 10.3109/13625187.2013.800855 Eur J Contracept Reprod Health Care Downloaded from informahealthcare.com by zakia ibrahim on 06/11/13 For personal use only.