Takeaway
- Preinsertion vaginal dinoprostone may improve ease of copper T380A intrauterine device (IUD) insertion in nulliparous women.
Why this matters
- Concern over difficulty of insertion of IUDs in nulliparous patients can be a barrier to receiving long-acting reversible contraception.
- Dinoprostone is a PGE2 often used for cervical ripening and labour induction.
Key results
- Physicians reported less difficulty in insertion with dinoprostone use (P<.01).
- Insertion failures were similar between groups.
- No cases of uterine perforation were reported.
- Women who received dinoprostone reported lower pain scores (3.7 vs 5.0; P<.01).
Study design
- Single-centre, double-blind, randomised controlled trial (n=240).
- Nulliparous women requesting a copper T380A IUD were randomly assigned to receive vaginal dinoprostone (3 mg) vs placebo 6 hours before IUD placement.
- Primary endpoint was the difference in ease of IUD insertion between study groups.
- IUD ease was reported by physicians responsible for IUD insertion using a graduated 10-cm visual scale from 0 to 10, where 0 denotes very easy insertion and 10 denotes extremely difficult insertion.
- Funding: None.
Limitations
- Pain scores are subjective.
- Insertion failures were similar between groups; pain scores lacked clinical significance.
References
References
