Objective: The aim of the study was to compare the efficacy and safety of misoprostol 200 mcg plus placebo vs. 400 mcg administered vaginally prior to IUCD insertion regarding the success and ease of insertion among parous women previously delivered by cesarean section beside the rate of occurrence of adverse effects.
Methods: This double blind randomized controlled clinical trial was conducted at Ain Shams University Maternity Hospital during the period from January 2020 till July 2020. One hundred parous women previously delivered by caesarean section were randomized into 2 groups; group (1): 50 women received misoprostol 400 mcg vaginally 3 hours prior to IUCD insertion and group (2): 50 women received misoprostol 200 mcg plus placebo vaginally 3 hours prior to IUCD insertion.
Results: There was insignificant difference between both groups; VAS ranged between 1 and 5 with a mean value of 2.16 ± 0.93 in group 1 and between 1 and 5 with a mean value of 2.55 ± 1.21 in group 2. There was insignificantly different between both groups. However, group 1 showed significantly lower need of analgesia than group 2 (P = 0.004). Successful IUD insertion was insignificantly different between both groups. Woman's level of satisfaction was insignificantly different between both groups. All side effects were insignificantly different between both groups except abdominal cramping and shivering were significantly lower in group 2 than in group 1.
Conclusion: We recommend using the lowest dose of misoprostol (200 mcg) prior to IUCD insertion.