PMID- 27741184
DCOM- 20170620
LR  - 20180213
IS  - 1873-233X (Electronic)
IS  - 0029-7844 (Linking)
VI  - 128
IP  - 5
DP  - 2016 Nov
TI  - Intrauterine Device Insertion Failure After Misoprostol Administration: A
      Systematic Review.
PG  - 1084-1091
AB  - OBJECTIVE: To examine rates of intrauterine device (IUD) insertion failure with
      and without prior misoprostol administration. Additional outcomes included
      difficulty of insertion, subjective pain, expulsion, and complications. DATA
      SOURCES: Systematic searches were performed in PubMed MEDLINE, Cochrane Central
      Register of Controlled Trials,, and Cumulative Index to
      Nursing and Allied Health Literature for articles with the following keywords:
      "misoprostol," "intrauterine devices," and "IUDs." METHODS OF STUDY SELECTION: A 
      total of 161 unique results were retrieved. Titles, abstracts, and full-text
      articles were independently screened twice by two reviewers for content and
      relevance. Quality assessment was performed using previously established
      criteria. After screening and quality assessment, nine randomized controlled
      trials (RCTs) were obtained for inclusion. Six articles were designated high
      quality and three were designated low quality. TABULATION, INTEGRATION, AND
      RESULTS: Six of six RCTs examining IUD insertion failure with misoprostol
      revealed no difference in this measure. Of nine RCTs examining difficulty of IUD 
      insertion with misoprostol, seven revealed no difference in this measure and two 
      revealed decreased difficulty of insertion with misoprostol administration. Of
      nine RCTs examining pain with IUD insertion, seven revealed no difference in pain
      measurement scores, one revealed increased pain with misoprostol administration, 
      and one revealed decreased pain with misoprostol administration. Five studies
      examining rates of expulsion and two studies examining complications of IUD
      insertion revealed no difference in this measure. CONCLUSION: No data support
      routine administration of misoprostol before IUD insertion. Success of insertion 
      is high even among nulliparous women, and good-quality data do not demonstrate
      that misoprostol use increases success. These data similarly reveal no
      differences in difficulty of insertion, pain with insertion, or expulsion with
      prior administration of misoprostol. However, data for several outcomes are
      limited by lack of power.
FAU - Matthews, Laura R
AU  - Matthews LR
AD  - Department of Obstetrics and Gynecology and Galter Health Sciences Library,
      Northwestern University Feinberg School of Medicine and John H. Stroger, Jr.
      Hospital, Cook County Health System, Chicago, Illinois.
FAU - O'Dwyer, Linda
AU  - O'Dwyer L
FAU - O'Neill, Erica
AU  - O'Neill E
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Obstet Gynecol
JT  - Obstetrics and gynecology
JID - 0401101
RN  - 0 (Abortifacient Agents, Nonsteroidal)
RN  - 0E43V0BB57 (Misoprostol)
SB  - IM
MH  - Abortifacient Agents, Nonsteroidal/*administration & dosage/adverse effects
MH  - Catheterization, Peripheral
MH  - Female
MH  - Humans
MH  - *Intrauterine Devices
MH  - Misoprostol/*administration & dosage/adverse effects
MH  - Pain/etiology
MH  - Pregnancy
MH  - Randomized Controlled Trials as Topic
EDAT- 2016/10/26 06:00
MHDA- 2017/06/21 06:00
CRDT- 2016/10/15 06:00
PHST- 2016/10/26 06:00 [pubmed]
PHST- 2017/06/21 06:00 [medline]
PHST- 2016/10/15 06:00 [entrez]
AID - 10.1097/AOG.0000000000001696 [doi]
PST - ppublish
SO  - Obstet Gynecol. 2016 Nov;128(5):1084-1091. doi: 10.1097/AOG.0000000000001696.