Intrauterine Contraceptive Devices: Insertion

Question 1

What should you do before inserting an IUD?

Answer 1

Screen for STIs:

• Chlamydia in women at risk
• Neisseria gonorrhoeae in women at risk in areas where it is prevalent.
• Any who request.

Question 2

If a woman is at risk of STIs, what should you do apart from testing before inserting the IUD?

Answer 2

Start prophylactic antibiotics before inserting it.

Question 3

What are the UKMEC Category 3 reasons for not inserting an IUD?

Answer 3

• It is between 48hrs to 4 weeks postpartum (Increased risk of perforation
• Initiation of method in women with ovarian cancer.

NOTE: Continuation of IUD is NOT UKMEC 3, only new insertion is.

Question 4

What are the UKMEC Category 4 reasons for not inserting an IUD?

Answer 4

• Pregnancy
• Current pelvic infection, puerperal sepsis, immediate post-septic abortion
• Unexplained vaginal bleeding which is suspicious
• Uterine fibroids or uterine anatomical abnormalities distorting the uterine cavity