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Subject Area

Obstetrics and Gynecology

Article Type

Original Study

Abstract

Objectives To evaluate whether combined use of vaginal misoprostol and cervical lignocaine spray before intrauterine contraceptive device (IUCD) insertion in scarred uteri will improve pain scores or not. Background IUCD is one of contraception methods commonly used worldwide. Pain associated with IUCD insertion is of interest. Misoprostol by its priming effect and lignocaine spray by its local anesthetic action on cervical mucosa may theoretically reduce pain. Patients and methods This randomized controlled clinical trial was conducted at the Department of Family Planning at Al Shohadaa Hospital from December 2018 to January 2020. Our study included nonpregnant women, 18–45 years old, delivered before by only cesarean section and desiring IUCD insertion. Group A included 48 women who received 400 μg misoprostol vaginally 3 h before IUCD insertion and lidocaine spray 10%, three puffs to the cervical surface and one puff to the external cervical os 3 min before IUCD insertion. Group B included 48 women who did not receive any medical interference. Follow-ups with primary and secondary outcomes were recorded. Results Our results showed that pain scores during sounding the uterus and IUCD insertion were of significant lesser level in group A; however, pain sores during Cusco insertion and during grasping the cervix showed nonsignificant difference between the two groups. Group A took significantly shorter duration than group B during IUCD insertion. Uterine length was significantly shorter in group A. Conclusion The combined use of vaginal misoprostol and lignocaine reduces the pain scores during IUCD insertion.

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