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I U C D• INTRODUCTION• CLASSIFICATION• MECHANISM OF ACTION• METHOD• SIDE EFFECTS /COMPLICATIONS/REMOVAL• EFFICACY• WHOM SUITABLE?• MISSING IUCD
Case scenario-1
• 26 years old ,P2L2, does not want to conceive any more.
-What choices would you offer her for contraception?
Case scenario-2
• A 30 years old P3L3 chose Cu-T as
her contraceptive choice.
-When would you ask her to come?
-How many years she can keep it?
-Give 2 adv and 2 disadvantages of IUCD.
INTRODUCTION
• A DEVICE WHICH IS PLACED IN UTERINE CAVITY WITH AIM OF PREVENTING PREGNANCY
• POPULAR METHOD IN DEVELOPING COUNTRIES
CLASSIFICATION
• NON MEDICATED : LIPPES LOOP
• MEDICATED : CuT 200,CuT380A
MULTILOAD275
• HORMONAL : PROGESTASERT
MIRENA( LNG)
TYPES OF IUCDS
COPPER-T 200
MULTILOAD
MIRENA - IUCD (LEVONORGESTREL)
MECHANISM -ACTION
• PREVENTS IMPLANTATION.• SPERMICIDAL ACTION• FORIGN BODY REACTION• CHEMICAL EFFECT OF COPPER• PROGESTERONE - DRY CERVICAL MUCUS
-ENDOMET.SUPPRESSED
METHOD
• TIMING :POST MENSTRUAL
POST ABORATL
POSTPARTUM• ASEPTIC PRECAUTIONS• PELVIC EXAMINATION• WITHDRAWAL / MODIFIED TECHNIQUE• FOLLOWUP : NEXT MENSES• CHECK FOR THREAD
SIDE EFFECTS
• MILD PAIN / DYSMEN
• MILD VAG DISCHARGE
• BACK ACHE
• INCREASED BLEEDING
COMPLICATIONS
• MENORRHAGIA
• P I D
• ? ECTOPIC PREGNANCY
• ? TUBAL INFERTILITY
• MISSING IUCD
• PERFORATION OF UTERUS
WHOM SUITABLE?
- INDICATIONS :
-PAROUS WOMEN
-POOR COMPLIANCE
- CONTRAINDICATIONS :
- A.U.B /SUSPECTED CA
- NULLIPARA
- STD/CSV/PID/FIBROID
- AT RISK FOR ECTOPIC
REMOVAL-INDICATIONS
• SEVERE BLEEDING• INFECTION• SEVERE ,CONSISTANT PAIN• PREGNANCY• LIFESPAN : CuT 200B - 4YRS
MULTILOAD 275-5YRS
MIRENA - 5 YEARS
• FAILURE RATE < 1 % - WRONG INSERTION - DISPLACEMENT - PERFORATION IF PREGNANCY - COUNSEL THE WOMAN - REMOVAL IF POSSIBLE - NO MAJOR PROBLEM IF
PREG CONTINUES
EFFICACY
MISSING THREAD /IUCD
• THREAD NOT SEEN /FELT :
-PREGNANCY
-EXPULSION
-MIGRATION /DISPLACED
. PREG TEST,ULTRA SCAN,X- RAY
ADVANTAGES
• ONE TIME SIMPLE OPD PROCEDURE
• COST EFFECTIVE
• EFFECTIVE – 99 %
• REVERSIBLE
• NO SYSTEMIC SIDE EFFECTS
• NO COMPLIANCE PROBLEM
MUST KNOW !
• THEORY :
• Eg : Classify IUCDs.Enlist 4 advantages
• and complications of CuT 200(2+4+4)
• SHORT NOTE :
• Copper –T,MissIng IUCD,removal ind.
• OSCE :
I U C D
DR Sathisha Nayak
Dept of obs. And gyne
Theory class-30-01-04 -6th semester