Objective: To evaluate the effect of misoprostol on the removal of pain of copper T380A intrauterine device (IUD) among women who had delivered by elective cesarean delivery (CS).
Study Design: The study was a randomized clinical trial.
Patients and methods: The study was conducted from the 1st of July 2019 to the 1st of July 2020 at Assiut Woman's Health Hospital, Egypt. Women who requested copper T380A IUD removal and delivered only by elective CS were included. The participants were assigned to the misoprostol group or no intervention group. The primary outcome was the difference in the intensity of immediate pain after IUD removal. Identification of potential predictors associated with high VAS immediately after IUD removal was explored. The data was analyzed using an unpaired t-test, chi-square test, Mann–Whitney U test, and multiple logistic regression.
Results: Eighty women were finally analyzed. The median of immediate VAS after IUD removal in the misoprostol group (4.0) was lower than the no-intervention group (6.0) with a statistically significant difference (p=0.000). A higher satisfaction score and lower ease score were also determined among the women in the misoprostol group. The longer time from IUD insertion, removal of IUD in non-menstruating women, women who did not use misoprostol before IUD removal, and women who did not use IUD before were significant clinical predictors associated with higher VAS immediately after IUD removal.
Conclusions: The use of vaginal misoprostol before copper T380A IUD removal reduces the removal pain and improves the ease and satisfaction among women who had delivered only by elective CS.