The use of misoprostol prior to intrauterine device insertion for nulliparous women

Author

Sara Lewis

Date of Award

2011

Document Type

Thesis

College/School

College of Nursing

Degree Name

Master of Science in Nursing (MSN)

Program Concentration

Nurse Midwifery

Abstract

Intrauterine devices are among the most effective and well-liked reversible methods of contraception, and used widely throughout the world, however misinformation among both clinicians and patients, as well as fears regarding the insertion procedure continue to limit their use in the US. This chronological review of the existing research examines the practice of cervical priming with misoprostol to ease insertion and make it less painful, especially among nulliparous women. Current evidence does not generally support this practice among parous or nulliparous women, however clinical judgment may allow for exceptions in certain cases, such as following history of failed or difficult insertion or cervical procedures, or hormonal states contributing to cervical stenosis. Also included is an updated evidence-based clinical guideline for the use of misoprostol prior to intrauterine device insertion. Keywords: misoprostol, intrauterine device, insertion, cervical priming

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