LARCs Flashcards
1
Q
IUD insertion
A
- Cat 2 (benefits outweighs risks)
- Can be inserted anytime in cycle as long as preg can be ruled out
- silent of hx of PID okay for insertion with single clinic visit
- if cervical cultures are positive, leave IUD in, and complete treatment
- complete treatment prior to insertion if ACTIVE infection
- first 4w increased risk PID, then done
2
Q
IUD & +preg test
A
- # 1 figure out if ectopic
- remove IUD if desired pregnancy (avoid chorio, abruption, previa, PTD, FGR)
3
Q
IUDs and ectopic pregnancy
A
- increased relative risk
- absolute risk very low
4
Q
IUD post aborion
A
- okay for immediate insertion all trimesters
- no back up needed
- CI if after septic abortion
5
Q
IUD and breast feeding
A
- Cat 2 (benefits outweighs risks)
- progesterone theoretically decreases milk supply, not supported in literature, still counsel pts
6
Q
Complications of IUDs
A
- expulsion
- perforation
- failure
7
Q
Copper IUD
A
- inhibits fertilization
- no abortifacient
- emergency contraception: 5d post intercourse
- NOT affected by obesity
- associated with increased menstrual bleeding
- no backup contraception needed
8
Q
Progesterone IUD
A
- varying dosing 13.5-20 ug prog daily
- inhibits fertilization: inhibits ovulation, thickens cervical mucous, alters endometrial lining
- not abortifacient
- SE: HA, nausea, ovarian cyst formation, breast tenderness
- decreased menstrual bleeding (treats AUB)
- backup contraception 7 days (unless immediate after abortion/child birth)
9
Q
Implants
A
- insert anytime during menstrual cycle if preg ruled out
- radio-opaque and visible on Xray
- surpasses ovulation, thickens cervical mucus and alters endometrial lining
- most effective method of reversible contraception (good for obese pts)
- menstrual irregularity (light & heavy), acne, weight gain
- !% chance insertion and removal complications
- lost implant found by XRAY, CT, or US
- return of fertility rapid after removal
- need backup contraception for 7d (unless immediate after abortion/child birth)
