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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.
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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)
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
EFFICACY • FAILURE RATE < 1 % - WRONG INSERTION - DISPLACEMENT - PERFORATION IF PREGNANCY - 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 • 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