Intrauterine contraceptive device Flashcards

1
Q

What is the IUCD? How does it work?

A

Plastic shapes with copper winding and a plastic thread for a tail

Prevent fertilisation by reducing sperm motility and survival, preventing sperm penetration of cervical mucus

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2
Q

What is the intrauterine system? How does it work?

A

Mirena - carries lenogestrel

Local effect - reversible endometrial atrophy - prevents endometrial proliferation - making implantiatno less likely and periods lighter and less painful

Thus also used in menorrhagia

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3
Q

Describe insertion of IUCD

A

Screen for STD prior to insertion
Can be inserted at any time as long as not pregnant
Effective immediately

Advise taking simple analgesia prior to insertion and warm her this may cause cramps

Teach how to feel the threads and ask to check after each period

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4
Q

When are IUS effective?

A

After 7 days

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5
Q

What are problems with IUCDs?

A
  1. May be expelled by a uterus which is nulliparous or distorted - 1 in 20
  2. Associated with PID up to 21d following insertion
  3. May cause dysmenorrhoea and manorrhagia
  4. Risk of ectopic pregnancy is 1:20 if she becomes pregnant
  5. Risk fo uterine perforation 2 per 1000
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6
Q

What are contraindications to IUCD?

A
Pregnancy
Current pelvic infection/STI
Pelvic inflammatory disease
Allergy to copper
Wilson's disease
Heavy/painful periods
Trophoblastic disease
Gynae malignancy
Abnormal uterine bleeding
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7
Q

When should IUCD be removed?

A

At menopause remove after 2 years amenorrhoea if <50, 1 years amenorrhoea if >50

If desired, start alternative contraception prior to removal

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8
Q

How long does Mirena coil last?

A

5 years

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9
Q

Which can be used for emergency contractions

A

IUCD

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10
Q

What are advantages of IUCD/IUS?

A

Very effective
Fertility returns to normal as soon as it is removed
Can be fitted at any stage of the cycle
Can be used by women who are breastfeeding
Can be used in most women for whom the COCP is contraindicated
Mirena coil often produces lighter, less painful periods
Copper coil is suitable for women who do not want hormonal contraception

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11
Q

What are disadvantages of IUCD/IUS?

A

No protection against STIs
Risk of ascending or iatrogenic infection
Risk of uterine perforation at fitting
Risk of body expelling IUD/IUS
Copper coil may make periods heavier and more painful
Most likely by adjustment period of irregular bleeding
Insertion of coil can be painful
Risk of ectopic
Increased risk of seizures in epileptics

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12
Q

When can copper IUD be inserted?

A

Any point during menstrual cycle
After first or second trimester abortion
From 4 weeks postpartum

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13
Q

hat is the most common side effect of IUS within first 6 months??

A

In the first 6 months following insertion of the intrauterine system, irregular bleeding is a common side effect. Eventually, most women using the IUS become oligomenorrhoeic or amenorrhoeic

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14
Q

When can women stop contraception?

A

After 1 year of amenorrhoea if > 50yo

AFter 2 years of amenorrhoea if < 50yo

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