IUCD INTRODUCTION CLASSIFICATION MECHANISM OF ACTION METHOD SIDE

Case scenario-1 • 26 years old , P 2 L 2, does not want

Case scenario-2 • A 30 years old P 3 L 3 chose Cu-T as

INTRODUCTION • A DEVICE WHICH IS PLACED IN UTERINE CAVITY WITH AIM OF PREVENTING

CLASSIFICATION • NON MEDICATED : LIPPES LOOP • MEDICATED • HORMONAL : Cu. T

MECHANISM -ACTION • • • PREVENTS IMPLANTATION. SPERMICIDAL ACTION FORIGN BODY REACTION CHEMICAL EFFECT

METHOD • TIMING : POST MENSTRUAL POST ABORATL POSTPARTUM • ASEPTIC PRECAUTIONS • PELVIC

SIDE EFFECTS • • MILD PAIN / DYSMEN MILD VAG DISCHARGE BACK ACHE INCREASED

COMPLICATIONS • • • MENORRHAGIA PID ? ECTOPIC PREGNANCY ? TUBAL INFERTILITY MISSING IUCD

WHOM SUITABLE? - - INDICATIONS : -PAROUS WOMEN -POOR COMPLIANCE CONTRAINDICATIONS : - A.

REMOVAL-INDICATIONS • • • SEVERE BLEEDING INFECTION SEVERE , CONSISTANT PAIN PREGNANCY LIFESPAN :

EFFICACY • FAILURE RATE IF PREGNANCY - <1% WRONG INSERTION DISPLACEMENT PERFORATION COUNSEL THE

MISSING THREAD /IUCD • THREAD NOT SEEN /FELT : -PREGNANCY -EXPULSION -MIGRATION /DISPLACED. PREG

ADVANTAGES • • • ONE TIME SIMPLE OPD PROCEDURE COST EFFECTIVE – 99 %

MUST KNOW ! • • • THEORY : Eg : Classify IUCDs. Enlist 4

IUCD DR Sathisha Nayak Dept of obs. And gyne Theory class-30 -01 -04 -6

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IUCD • • INTRODUCTION CLASSIFICATION MECHANISM OF ACTION METHOD SIDE EFFECTS /COMPLICATIONS/REMOVAL EFFICACY WHOM SUITABLE? MISSING IUCD

Case scenario-1 • 26 years old , P 2 L 2, does not want to conceive any more. -What choices would you offer her for contraception?

Case scenario-2 • A 30 years old P 3 L 3 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 • HORMONAL : Cu. T 200, Cu. T 380 A MULTILOAD 275 : 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 PID ? 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 : Cu. T 200 B - 4 YRS MULTILOAD 275 -5 YRS MIRENA - 5 YEARS

EFFICACY • FAILURE RATE IF PREGNANCY - <1% WRONG INSERTION DISPLACEMENT PERFORATION COUNSEL THE WOMAN REMOVAL IF POSSIBLE NO MAJOR PROBLEM IF PREG CONTINUES

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 – 99 % REVERSIBLE NO SYSTEMIC SIDE EFFECTS NO COMPLIANCE PROBLEM

MUST KNOW ! • • • THEORY : Eg : Classify IUCDs. Enlist 4 advantages and complications of Cu. T 200(2+4+4) SHORT NOTE : Copper –T, Miss. Ing IUCD, removal ind. OSCE :

IUCD DR Sathisha Nayak Dept of obs. And gyne Theory class-30 -01 -04 -6 th semester