IUDIUD

COPPER T INSERTIONCOPPER T INSERTION-- SayeedaSayeeda AfzalAfzal

IUDIUD

Contraceptive methods.Contraceptive methods.Preventive method to help women to avoid Preventive method to help women to avoid unwanted pregnancies.unwanted pregnancies.It is a small flexible plastic frame with a It is a small flexible plastic frame with a copper wire on it.copper wire on it.It is inserted in to a woman’s uterus It is inserted in to a woman’s uterus through her vagina.through her vagina.

TYPES OF IUDTYPES OF IUD

1.1. Inert devices Inert devices ––lippeslippes loop.loop.2.2. Copper carrying devices Copper carrying devices ––cu Tcu T--200.200.3.3. Hormone containing devices Hormone containing devices --MirenaMirena

TYPES OF COPPER TTYPES OF COPPER T

Copper 7Copper 7Copper TCopper T--200200T CU T CU --220 C220 CT CU T CU --380 A380 ANOVA TNOVA TMULTILOAD DEVICESMULTILOAD DEVICES

MECH.. OF ACTIONMECH.. OF ACTION

1.1. Acts like foreign bodyActs like foreign body--prevents migration of prevents migration of sperm,provokessperm,provokes uterine contractility.uterine contractility.

2.2. LeucocyteLeucocyte infiltration.infiltration.3.3. Copper Copper –– enzymatic & metabolic changes.enzymatic & metabolic changes.4.4. ProgesteronProgesteron ––alteration in cervical alteration in cervical

mucus,endometrialmucus,endometrial atrophy, prevents atrophy, prevents ovulation.ovulation.

Patient selectionPatient selection

1.1. Who has borne at least 1 child.Who has borne at least 1 child.2.2. No No h/oh/o pelvic diseases.pelvic diseases.3.3. Monogamous relationship.Monogamous relationship.4.4. Has access to follow up & treatment.Has access to follow up & treatment.5.5. Desirous of Desirous of longtermlongterm reversible method reversible method

of contraception.of contraception.

Method of insertion…Method of insertion…

History taking & Ex to exclude any History taking & Ex to exclude any contraindications for insertion.contraindications for insertion.Done in the OP with aseptic precautions Done in the OP with aseptic precautions without without anaesthesiaanaesthesia..Patient has to empty her bladder & placed Patient has to empty her bladder & placed in in lithotomylithotomy position.position.Placement of the device inside the inserterPlacement of the device inside the inserter

Pelvic Ex for uterine size & position.Pelvic Ex for uterine size & position.Post.. Vaginal speculum is introduced & Post.. Vaginal speculum is introduced & vagina & cervix are cleaned by antiseptic vagina & cervix are cleaned by antiseptic lotion.lotion.A sound is passed thro’ the A sound is passed thro’ the cxcx to note the to note the position and size of uterine cavity & the position and size of uterine cavity & the device is adjusted.device is adjusted.

The inserter is introduced up to the The inserter is introduced up to the fundusfundusafter positioning it by the after positioning it by the guard,theguard,the inserter inserter is withdrawn keeping the plunger in is withdrawn keeping the plunger in position. position. ––WITHDRAWAL METHOD.WITHDRAWAL METHOD.EXCESS OF NYLON THREAD IS CUTEXCESS OF NYLON THREAD IS CUT

INSTRUCTIONS TO THE INSTRUCTIONS TO THE PATIENTPATIENT

1.1. Possible symptoms of pain & vaginal Possible symptoms of pain & vaginal bleeding should explained.bleeding should explained.

2.2. She is She is advicedadviced to feel the thread to feel the thread periodically.periodically.

3.3. She is checked after 1 month & then She is checked after 1 month & then anuallyanually..

contraindicationscontraindications

1.1. Suspected pregnancy.Suspected pregnancy.2.2. PIDPID3.3. Fibroids.Fibroids.4.4. MenorrhagiaMenorrhagia & & dysmemorrhoeadysmemorrhoea if cu T is used.if cu T is used.5.5. AnemiaAnemia6.6. PrevPrev.. .. EctopicEctopic pregnancy.pregnancy.7.7. Scarred uterus.Scarred uterus.8.8. Carcinoma cervix and uterus.Carcinoma cervix and uterus.

REFERENCESREFERENCES

PARK’S textbook of preventive & social PARK’S textbook of preventive & social medicine.medicine.The essentials of contraceptive tech.The essentials of contraceptive tech.DuttaDutta ––textbook of obstetrics.textbook of obstetrics.

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