Transcript I U C D - Tripod.com

IUCD
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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
• HORMONAL
: CuT 200,CuT380A
MULTILOAD275
: PROGESTASERT
MIRENA( LNG)
TYPES OF IUCDS
COPPER-T 200
MULTILOAD
MIRENA - IUCD (LEVONORGESTREL)
MECHANISM -ACTION
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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
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MILD PAIN / DYSMEN
MILD VAG DISCHARGE
BACK ACHE
INCREASED BLEEDING
COMPLICATIONS
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MENORRHAGIA
PID
? ECTOPIC PREGNANCY
? TUBAL INFERTILITY
MISSING IUCD
PERFORATION OF UTERUS
WHOM SUITABLE?
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INDICATIONS :
-PAROUS WOMEN
-POOR COMPLIANCE
CONTRAINDICATIONS :
- A.U.B /SUSPECTED CA
- NULLIPARA
- STD/CSV/PID/FIBROID
- AT RISK FOR ECTOPIC
REMOVAL-INDICATIONS
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SEVERE BLEEDING
INFECTION
SEVERE ,CONSISTANT PAIN
PREGNANCY
LIFESPAN : CuT 200B
- 4YRS
MULTILOAD 275-5YRS
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
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ONE TIME SIMPLE OPD PROCEDURE
COST EFFECTIVE
EFFECTIVE – 99 %
REVERSIBLE
NO SYSTEMIC SIDE EFFECTS
NO COMPLIANCE PROBLEM
MUST KNOW !
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THEORY
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Eg : Classify IUCDs.Enlist 4 advantages
and complications of CuT 200(2+4+4)
SHORT NOTE :
Copper –T,MissIng IUCD,removal ind.
OSCE
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IUCD
DR Sathisha Nayak
Dept of obs. And gyne
Theory class-30-01-04 -6th semester