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Pregnancy with IUCD in situ

O & G Department. Pregnancy with IUCD in situ. Dr. Anand Gangji. IUCD efficacy. 0.6 – 0.8 % at 1 year for Cu IUCD 0.2 – 0.3 % at 1 year for LNG IUS Highest risk of failure in first year Malposition of IUCD. Misplaced IUCD with intrauterine pregnancy. Pregnancy with IUCD.

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Pregnancy with IUCD in situ

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  1. O & G Department Pregnancy with IUCD in situ Dr. Anand Gangji

  2. IUCD efficacy • 0.6 – 0.8 % at 1 year for Cu IUCD • 0.2 – 0.3 % at 1 year for LNG IUS • Highest risk of failure in first year • Malposition of IUCD

  3. Misplaced IUCD with intrauterine pregnancy

  4. Pregnancy with IUCD • Woman’s Intention for the pregnancy • IUCD strings visible • Location of pregnancy • Gestation

  5. Pregnancy with IUCD • Early risks – Miscarriage, sepsis • Late risks – Preterm delivery, Chorioamnionitis • No increased risk of birth defects • Removal – increased risk of miscarriage, infection, preterm delivery

  6. First trimester • Wanted pregnancy, strings seen – Remove IUCD • Wants termination, strings seen – Remove IUCD • Ectopic pregnancy, strings seen – Remove IUCD and manage ectopic by surgery • Medical management of ectopic, IUCD may be left in situ.

  7. First trimester • Strings not seen, wanted Intrauterine pregnancy – counsel risks, +/- USS guidance removal • Strings not seen, Ectopic pregnancy - manage ectopic pregnancy, search for IUCD at the time of procedure

  8. Second trimester • String seen, wanted pregnancy – remove IUCD • String not seen, wanted pregnancy – counsel, USS guidance • Unwanted pregnancy, if strings seen – remove, plan medical termination • Antibiotic cover

  9. Jadelle (LNG implant) • Pregnancy symptoms • Risk of ectopic 1 in 2000 HWY of use • Removal • No increased risk of birth defects

  10. Thank you

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