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العنوان
Cervical Priming with Vaginal
Misoprostol Prior to Insertion of an
Intrauterine Contraceptive Device
المؤلف
Nassar,Salma Ashraf Mohamed
هيئة الاعداد
باحث / Salma Ashraf Mohamed Nassar
مشرف / Maged Ramdan Abouseeda
مشرف / Ahmed Mohamed Mamdouh
الموضوع
Cervical Priming-
تاريخ النشر
2013
عدد الصفحات
130.p:
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
أمراض النساء والتوليد
تاريخ الإجازة
1/1/2013
مكان الإجازة
جامعة عين شمس - كلية الطب - Obstetrics and Gynecology
الفهرس
Only 14 pages are availabe for public view

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from 130

Abstract

The intrauterine contraceptive device (IUCD) provides
long-term, reversible contraception equal in efficacy to tubal
sterilization. Depending on the country, the use of IUCDs
worldwide ranges from 2%to 75%. On average, 15% of
reproductive-aged women in developing countries and 8% in
developed countries use IUCDs. Increasing the number of
women using IUCDs is an important public health goal
(Grimes, 2008).
One barrier to IUCD use is the fear of pain during
insertion. Components of the insertion procedure that may
cause pain include the application of the tenaculum to the
cervix to stabilize the uterus and provide traction for
straightening the cervical canal, passing the uterine sound,
inserting the IUCD in the inserter tube through the cervix, and
irritation of the endometrial cavity with the device
(d’Arcangues, 2007).
The levels of pain that women experience during IUCD
insertion vary in published reports. Most women experience
mild to moderate discomfort during IUCD insertion. Rarely, the
pain is severe and associated with nausea and weakness. Pain
may persist for a few days after insertion. Predictors of pain
during IUCD insertion include nulliparity, age greater than 30
years, lengthier time since last pregnancy or last menses, and
not currently breastfeeding. Psychosocial factors including expected pain also influence the pain perceived by women
undergoing the procedure (Hubacher, 2007).
The use of prophylactic non steroidal anti-inflammatory
drugs (NSAIDs) prior to IUCD insertion has been advocated to
reduce pain during insertion and has been common practice for
years (Saav et al., 2007).
However, in a larger randomised controlled trial (RCT)
comparing prophylactic 400mg ibuprofen with placebo prior to
IUCD insertion, no pain reduction was shown (Hubacher et al.,
2006).
Misoprostol is an inexpensive prostaglandin E1-
analogue, which is associated with few side-effects (Goldberg
et al., 2001; Wing andAffaney, 2006) and an effective method
for treatment of missed and incomplete abortion, induction of
provocative abortion as well as for labor induction and
prevention and treatment of postpartum haemorrhage (Goldberg
et al., 2001).