The effect of nitroprusside on the IUD insertion experience in nulligravid women: a pilot study

A randomized double blinded clinical trial to explore the clinical outcomes of vaginal isonicotinic acid hydrazide (INH) administration six hours prior to T380A intrauterine device insertion in persons delivered only by cesarean delivery

OBJECTIVE

To compare insertion pain and ease of insertion in participants with a prior caesarean delivery having copper intrauterine device (IUD) after pretreatment with isonicotinic acid hydrazide (INH) 900 mg vaginally or placebo.

STUDY DESIGN

From September 2020 to September 2021, we conducted a randomized, double-blind, placebo-controlled experiment at Aswan University Hospital in Egypt with participants who were delivered solely by caesarean delivery and desired copper T380A IUD insertion. The participants were randomly assigned to either vaginal INH or placebo six hours before IUD insertion in a 1:1 ratio. The primary objective of the research was the individuals' self-reported pain during cervical tenaculum placement, sound insertion, IUD insertion, and 5 minutes after the placement, as measured by a 10-cm visual analogue scale (VAS). Our secondary outcomes were ease of insertion, satisfaction, the need for analgesics, and adverse effects. IUD insertion ease was graded from 0 to 10 on a 10-cm VAS scale, with 0 suggesting very easy insertion and 10 denoting extremely difficult insertion.

RESULTS

When compared to the placebo group, the INH group experienced considerably less pain during IUD insertion (2.9±0.85vs.5.11±0.82;p<0.01), lower median ease of insertion score (3(1-4)vs.5(3-6);p<0.01), and better satisfaction (8.17±0.69vs.5.57±0.75). The two groups had comparable side effects.

CONCLUSIONS

Vaginal INH administered before IUD insertion reduce the amount of discomfort participants feel throughout the process in individuals who had previously only been delivered via CD. It also has the potential to make insertion easier.

IMPLICATIONS

In participants who were delivered solely by CD before, vaginal INH given prior to IUD placement reduces the amount of discomfort participants experience throughout the procedure. Furthermore, it could increase the ease of insertion.

Ultrasound-guided intrauterine device insertion: a step closer to painless insertion: a randomized control trial

AIM OF STUDY

To reduce the pain and duration of the intrauterine device (IUD) insertion procedure through minimizing instrumentation and using trans-abdominal sonography (TAS).

METHODS

This randomized control trial was conducted in a university hospital and included 102 eligible females, fulfilling the inclusion criteria. They were randomly assigned into two groups via 1:1 computer-based randomization program; the trans-abdominal guided IUD insertion group (n = 51), and the traditional IUD insertion group (n = 51). The main outcomes were the pain experienced during the procedure as scored by the visual analogue score and the duration of the procedure.

RESULTS

The trans-abdominal guided IUD insertion was found to be statistically superior to the traditional technique for IUD insertion regarding the pain scores (according to the Visual Analogue Scale, from 0 to 10) recorded by the candidates (2.4 ± 2.1 vs. 5.0 ± 1.7, p < .001) as well as the time (in seconds) taken for IUD insertion procedure (32.2 ± 14.8 vs. 77.7 ± 30.6, p < .001).

CONCLUSIONS

Due to the decrease in pain and time taken for IUD insertion, the trans-abdominal guided technique can be used as a modified technique for IUD insertion. ClinicalTrials.gov Identifier: NCT02582268.