IUD Flashcards
1
Q
Who is the IUD NOT suitable for?
A
- unexplained vaginal bleeding
- post partum women between 48 hours and 4 weeks post-delivery
- post-partum/abortion sepsis
- persistently high b-HCG or malignant gestational trophoblastic disease
- cervical ca awaiting treatment
- endometrial ca
- current PID
- symptomatic chlamydia OR gonorrhoea
- known pelvic TB
- known serious cardiac conditions/arrhythmias where vasovagal could be fatal
- HIV +ive with CD4 <200
2
Q
What is the mechanism of action of IUD?
A
- MAIN: prevent fertilisation through a foreign body effect and the copper ions toxicity to sperm and ova
- it increases the number of leucocytes in the endometrium, creating an inflammatory response. copper also affects endotheilial enzymes, glycogen metabolism and oestrogen uptake
- copper inhibits sperm penetration
3
Q
What are the advantages of IUD?
A
- LARC, highly effective and no delay in fertility
- non-hormonal so no hormonal SEs
- effective immediately
- not affected by liver enzyme inducing meds
- ca be used when breastfeeding
- most effective EC
- High acceptability - 1st year continuation at 80%
- Protective for endometrial ca
4
Q
A
