i u c d introduction classification mechanism of action method side effects /complications/removal...

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