Intrauterine Contraception Flashcards
(54 cards)
an LNG-IUD fitted after 45 can be used for contraception until ?
Age 55
Under 45 an LNG-IUD can be used for ?
8 years
Cu-IUD with more than 300mm squared of copper inserted after age (1) can be kept until menopause or 1 year after the last period if under (2) and 2 year after last period is under (3)
- 40
- 50
- 40
Copper coils effectiveness with perfect use (1) with typical use (2) in first year of use.
- 99.4%
- 99.2%
Failure rate for a 52mg LNG-IUD ?
99.8% effective in first year of use
Effectiveness of 19.5 and 13.5mg devices
99.7%
What UKMEC is IUC insertions between 48 hours and 28 days post delivery ?
UKMEC 3 - shouldn’t really be doing it risk outweighs benefit
UKMEC for know distortions of uterine cavity ?
UKMEC3
Is the copper coil still effective in immunocompromised or suppressed people ?
Yes it is
For individual at risk of adrenal crisis what measure need to be taken ?
Their appointment should be first thing in the morning and they need to take a double dose of glucocorticoids 1 hours before the procedure and 24 hours after. Mineralocorticoids do not need to be adjusted.
Ehlers-Danlos patients are at increased risk of perforation what should we do when fitting their coils ?
Discuss appropriate setting with EDS specialist, and assure positioning appropriate for the patient
What considerations need to be taken into place for individuals with PoTS ?
Should be a straight forward procedure, assure hydrated and awareness into transition of positions
What is PoTS ?
People with PoTS experience an abnormal increase in heart rate when they transition from lying down to standing up.
What is Eisenmenger Physiology
Happens to people that have a congenital defect and have a left to right shunt (oxygenated to deoxygenated blood), then due pulmonary hypertension this reversed to a right to left shunt, which is an issue
Why should some cardiac patient be done in hospital ?
those with arrhythmia, long QT and impaired ventricular function, should be done in hospital as a vasovagal poses significant risk of an cardiac event
What precautions should be taken for someone that is anti coagulated and requires a coil ?
an experienced clinician should do the procedure and time the procedure away from when medications is taken and ensure haemostat agents are available
Precautions with inherited bleeding disorders ?
check with their haematologist
In which rare genetic disorder is a copper coil contraindicated ?
Wilson’s disease
Is presence of or history of ovarian cysts a contraindication to a LNG-IUC ?
No
Is the increased incidence of ovarian cysts with LNG-IUD of clinical significance ?
No
In which time frame after coil fit is the risk of infection the highest ?
In the first three weeks, however overall risk is less than 1%
Actinomycoes like organism on cervical cytology, what are you going to do ?
Nothing, its likely a colonisation rather then infection. If an infection is suspected raise with radiology, microbiology and gynae, might require some high dose penicillin for 2-6 weeks, initially IV. IF penicillin allergic, then we are looking at cef, doxy or erythromycin.
When does expulsion tend to be most common ?
Within the first year of use, especially the first 3 months.
In who are expulsion rates higher ?
Those that have had a device fitted after late first or second trimester abortion, adolescents, HMB, distorted cavity , menstrual cup used and previous expulsion
