misoprostol and Pelvic-Pain

The aims of this study were to compare three different interventions to reduce pain related to insertion of the intrauterine device (IUD), namely, lidocaine, misoprostol and a non-steroidal anti-inflammatory drug, against a placebo, and to assess the advantages of one drug over another, if any.. This was an open-label randomised placebo-controlled trial of 200 women assigned to receive one of the following medications prior to IUD insertion: 10 ml 1% lidocaine paracervical block, 400 μg oral misoprostol, oral naproxen or placebo tablets. The primary outcome measure was the level of pain experienced at different steps of IUD insertion and 15 min after the procedure, measured by a visual analogue scale (VAS).. Between July 2015 and March 2016, 208 women were invited to participate in the study: eight refused and the remaining 200 women were randomised equally into four treatment groups (50 participants in each group). All characteristics were similar between the groups. The mean pain scores recorded during speculum placement, tenaculum application, uterine sounding, IUD insertion and 15 min after insertion were similar among the four groups (p > .05). Adjuvant methods to facilitate insertion, insertion failure or device expulsion were similar between the groups (p > .05). Complications were reported in 17 participants (8.5%); all resolved spontaneously with no further management (p > .05).. Despite finding that none of the study drugs seemed effective prior to IUD insertion, insertion did not cause severe pain. The negative findings indicate the need for future research into new strategies to decrease pain during IUD placement.

Topics: Adult; Analgesics; Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Female; Humans; Intrauterine Devices; Lidocaine; Misoprostol; Naproxen; Oxytocics; Pain Management; Pain, Procedural; Pelvic Pain; Prosthesis Implantation; Treatment Outcome; Young Adult

Misoprostol has been studied intensively to produce cervical dilatation. To date, no studies have evaluated the effectiveness, safety or acceptability of this treatment for repeat intrauterine device insertions.. This study was a randomized, double-blind, placebo-controlled trial on the consecutive use of the levonorgestrel-releasing intrauterine system (LNG-IUS). Women who had used their first LNG-IUS for 4 years and 3 to 9 months and opted for an immediate replacement with a second LNG-IUS received a single sublingual dose of 400 mcg misoprostol or placebo 3 h prior to the LNG-IUS insertion.. The proportion of easy insertions as judged by the investigator was 93% (40/43) in subjects randomized to misoprostol and 91% (42/46) in the placebo group (p=1.0 for the difference of proportions). No or mild pain at insertion was reported by 37% and 35% of subjects in the misoprostol and placebo groups, respectively. However, adverse events related to the study drug were more common in the misoprostol group.. Sublingual misoprostol did not have a significant effect on the ease of insertion in subjects having a repeat insertion of the LNG-IUS.

Topics: Administration, Sublingual; Adult; Cervix Uteri; Contraceptive Agents, Female; Dilatation; Double-Blind Method; Female; Humans; Intrauterine Devices, Medicated; Levonorgestrel; Misoprostol; Pain Measurement; Pelvic Pain; Premedication

To evaluate the effectiveness and acceptability of expectant management of induced and spontaneous first trimester incomplete abortion.. A prospective observational trial, conducted between June 2006 and November 2007, of 2 groups of patients diagnosed with an incomplete abortion: 66 patients who had received misoprostol for an induced abortion (group 1) and 30 patients who had had a spontaneous abortion (group 2). Transvaginal ultrasound was performed weekly. The success rate (complete abortion without surgery), time to resolution, duration of bleeding and pelvic pain, rate of infection, number of unscheduled hospital visits, and level of satisfaction with expectant management were recorded.. The incidence of complete abortion was 86.4% and 82.1% in groups 1 and 2 respectively at day 14 after diagnosis, and 100% in both groups at day 30 (two group 2 patients underwent curettage and were excluded from the analysis). Both groups reported 100% satisfaction with expectant management, although over 90% of the women reported feeling anxious.. Expectant management for incomplete abortion in the first trimester after use of misoprostol or after spontaneous abortion may be practical and feasible, although it may increase anxiety associated with the impending abortion.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Incomplete; Abortion, Spontaneous; Adult; Anxiety; Female; Follow-Up Studies; Humans; Misoprostol; Patient Satisfaction; Pelvic Pain; Pregnancy; Pregnancy Trimester, First; Prospective Studies; Time Factors; Treatment Outcome; Ultrasonography; Uterine Hemorrhage; Young Adult

A prospective randomized controlled trial was conducted to compare the efficacy and side-effects of vaginal versus oral misoprostol in the medical management of incomplete miscarriage.. Two hundred and one patients who miscarried consented to randomization using computer-generated randomization model prior to treatment. A total of 800 microg of misoprostol was given either vaginally or orally to the randomized subjects. A second dose was repeated 4 h later if the product of conception had not been passed.. The incidence of complete uterine evacuation following vaginal and oral misoprostol was similar [(58/95) 61.1% versus (67/103) 64.4%]. There was a significantly decreased incidence of diarrhoea [(12/95) 13.6% versus (62/103) 65.3%, P < 0.01] with the use of vaginal misoprostol.. Vaginal misoprostol was as effective as oral misoprostol in medical uterine evacuation in patients with incomplete miscarriage. There was also a reduction in the incidence of diarrhoea with the use of vaginal misoprostol.

Topics: Abortion, Incomplete; Administration, Intravaginal; Administration, Oral; Adult; Diarrhea; Female; Humans; Misoprostol; Pelvic Pain; Pregnancy

A study was undertaken to determine whether the combination of oral tamoxifen and moistened misoprostol administered vaginally was superior to that of placebo and moistened misoprostol administered vaginally for elective termination of early pregnancies.A clinical trial was conducted with a study group of 150 healthy women with pregnancies of

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Diarrhea; Double-Blind Method; Estrogen Antagonists; Female; Hemoglobins; Humans; Misoprostol; Patient Satisfaction; Pelvic Pain; Pregnancy; Prospective Studies; Tamoxifen; Ultrasonography, Prenatal; Uterine Hemorrhage; Vomiting

To study the complications and compare the success rate and abortion time between the live and the dead fetuses in second-trimester pregnancy termination with intracervicovaginal misoprostol.. A prospective comparative study.. A total of 89 pregnant women between 14 and 28 weeks of gestation with obstetric, medical, or genetic reasons for termination of pregnancy were recruited to receive 200 micrograms misoprostol inserted intracervicovaginally every 12 hours.. The rates of successful abortions within 12, 24 and 48 hours in live fetuses were 15.1%, 54.7% and 92.5%, respectively, while in dead fetuses were 50.0%, 83.3% and 97.2%, respectively. The success rates within 12 and 24 hours in live-fetus group were significantly lower than those of the dead-fetus group 9p = 0.0009 and p = 0.01, respectively). The mean abortion time of the live-fetus group (27.1 hours) was significantly more than that of the dead-fetus group (15 hours, p = 0.001). No serious complications occurred in terms of hemorrhage, febrile morbidity diarrhea, nausea and vomiting.. Intracervicovaginal misoprostol is an effective and safe method for second-trimester pregnancy termination. The success rate is higher and the abortion time is less in dead-fetus pregnancy than those in the live-fetus pregnancy.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Administration, Intravaginal; Adult; Analgesia; Cohort Studies; Female; Fetal Death; Fetus; Gels; Humans; Misoprostol; Oxytocin; Pelvic Pain; Pregnancy; Pregnancy Trimester, Second; Prospective Studies; Time Factors

To assess the efficacy of medical abortion and patient satisfaction in the clinic setting, in addition to determining healthcare providers' views.. From 2006 to 2008, 2400 women were enrolled at 10 Vietnam Family Planning Association (VINAFPA) clinics in an operations research project. Participants took 200mg of oral mifepristone in the clinic and 400 μg of oral misoprostol 2 days later at home or in the clinic. Abortion status was assessed at follow-up. Furthermore, in 2006, 900 clinicians at 45 health facilities answered a knowledge, attitudes, and practices survey to capture providers' views.. In total, 93.8% of participants had successful medical abortions. The majority (84.5%) administered misoprostol at home. Adverse effects included bleeding, pain/cramps, and nausea. Most women (92.6%) were satisfied/very satisfied with the method. Most providers who took the survey (85.6%) recommended that medical abortion be introduced at VINAFPA clinics.. The operations research data demonstrate the safety, efficacy, and acceptability of medical abortion at VINAFPA clinics. The majority of surveyed providers endorsed adding medical abortion at their own facilities. Developing national guidelines for providing medical abortion at the clinic level is an important step in expanding access to services in Vietnam.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Induced; Adolescent; Adult; Female; Health Care Surveys; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Humans; Middle Aged; Misoprostol; Nausea; Patient Satisfaction; Pelvic Pain; Pregnancy; Self Administration; Treatment Outcome; Vietnam; Young Adult

Therapeutic interruption of the pregnancies of the 2nd and 3-rd quarter is often badly accepted by the patients and it is original that his realization is easy, effective and the less traumatic possible. In this indication, the sulprostone (Nalador) is a big contribution.. The purpose of our study is to review this product, to describe our experience concerning its use in the therapeutic interruptions of pregnancies and to study alternatives in case of failure or of against indication in its use.. It is about a forward-looking study opened from the 01-07-02 led in the service "A" of the CMNT. We brought together 30 women where a therapeutic interruption of the pregnancy was put and who did'nt present of against indications to the sulprostone.. The average age was of 27 years with extremes from 18 to 39 years 50% of our patients were nullipares. The terms of pregnancy varied from 16 to 28 LIMITED COMPANIES with an average of 20 LIMITED COMPANIES. The indications of these terminations of pregnancy were maternal in 33.33% of cases and foetal in 66.66% of cases. The average number of light bulbs of Nalador used by the women was of 2.25 with extremes going from 1 to 4. The delay of eviction from the beginning of the induction was on average of 21 hours, with a rate of success of 90%. We did not regret any break uterine Delivery was incomplete requiring a uterine revision under general anesthetic in 5 cases. Tolerance was good in general In case of failure alternatives were: the misoprostol (cytotec *), the Probe extra amniotic dries and the wet Probe.. The sulprostone by intravenous way constitutes an effective method of medical interruption of the pregnancy in the 2-nd and 3-rd quarter with a satisfactory tolerance and a rate of success of 90 %.

Topics: Abortifacient Agents, Nonsteroidal; Abortion, Therapeutic; Adolescent; Adult; Congenital Abnormalities; Diarrhea; Dinoprostone; Female; Fetal Death; Gestational Age; Humans; Misoprostol; Parity; Pelvic Pain; Pregnancy; Prospective Studies; Time Factors; Treatment Outcome; Vomiting