INTRAUTERINE CONTRACEPTIVE DEVICES

-

 IUCDs



Intrauterine contraceptive have been in use for several decades. The closed devices like Grafenberg ring, and birnberg bow are obsolete now. Open devices like Copper T, Copper 7 and lippes loop were in use in 1980s.  


Commonly used IUCDs in present day practice are:
 Cu T 200, Cu T 380 A, Multiload 250, Multiload 350, Progestasert, Levonorgesterel intrauterine device and others.

MECHANISM OF ACTION

Mechanism of antifertility effects of IUCDs is not yet clear.

PROBABLE FACTORS

- It interferes with sperm transportation from the cervix to the fallopian tubes.
- The IUCD inhibits sperm capacitation and survival (speroff et al, 1999).
- It alters the biochemical or cellular composition of uterine fluid or both causing  impairment of the viability of gametes.
- The copper ions released from the device interferes with sperm motility and creates a reaction that results in a spermicidal endometrium (Nelson, 2000).
- Progestasert is thought to act through thickening the cervical mucus and rendering it impermeable to sperm.

TIME OF INSERTION

-Interval insertion: Inserted 6 weeks after delivery or abortion. The timing should preferably be within 2 to 3 days of completion of menses. During the period of lactational amenorrhea it should be inserted after ensuring that the women is not pregnant. 
-Postabortal or insertion: Insertion immediately following delivery of the placenta. Expulsion rate is high.
- Postpartal: Insertion before the patient is discharged from the hospital following delivery.

COMPLICATIONS

- Cramping pain.
- Syncope following a vasovagal attack.
- Uterine perforation- partial or complete.
- Pelvic infection- infertility.
- Menorrhagia.
- Intermenstrual bleeding.
- Dysmenorrhea.
- Unwanted pregnancy.
- Spontaneous expulsion.

ADVANTAGES

- Provides excellent contraception.
- May be used successfully in lactating women.
- Indicated in women in whom oral contraceptive are contraindicated.
- Can be used over long periods of time.
- Action easily reversible.
- Progesterone IUCDs reduce dysmenorrhea and menorrhagia.

DISADVANTAGES AND CAUTION

- IUCDs do not provide protection against STDs.
- Cannot be used in patients with suspected pelvic infection.
- Best avoided in women having multiple sex partners.
- Menstrual disturbances such as menorrhagia.
- Dysmenorrhea.
- Women with valvular heart disease- risk of bacterial endocarditis.
- Uterine anomalies.
- Previous ectopic pregnancy.
- Women with abnormal Pap smears.

REMOVAL

This may be required because:
- The life span of the IUCD has been completed.
- The patient does not tolerate the IUCD.
- The patient has conceived with the IUCD.
- The IUCD has got displaced downwards.
- The women desires to conceive.
The median time from removal of IUCD to planned pregnancy is 3 months (Nelson, 2000).


HOPE YOU LIKE IT...

Comments

Post a Comment

Popular posts from this blog

Tha Basic Steps of breast examination

-
Image
 BREAST Examination  Visual Inspection: Stand in front of a mirror with your arms at your sides. Look for any changes in size, shape, or contour. Also, check for skin changes or redness. Raise Your Arms: Raise your arms and look for the same changes. Check Your Breasts Lying Down: Lie down, and with your right arm behind your head, use your left hand to feel your right breast. Use a circular motion, covering the entire breast and armpit area. Repeat on the other side. Check Your Breasts Sitting Up: Use the same circular motion while sitting up. Feel for Lumps: Use varying pressure levels to feel for any lumps or abnormalities. Pay attention to any changes in texture or the presence of lumps. Check Nipples: Look for any changes in the nipples, such as discharge or inversion. Introduction: Breast examination plays a crucial role in early detection of breast abnormalities, including cancer. Empowering women with the knowledge and skills to perform regular self-examinations is a key
Read more

Brain Tumors- cause and symptoms

-
Image
 Understanding Brain Tumors: Types, Symptoms, and Treatments Introduction A brain tumor is an abnormal growth of cells in the brain or surrounding tissues. These tumors can be either benign (non-cancerous) or malignant (cancerous), and they vary widely in their behavior, treatment options, and prognosis. This article provides an overview of brain tumors, including their types, symptoms, diagnosis, and treatments. Types of Brain Tumors Brain tumors are classified based on the type of cell they originate from and their location within the brain. The main categories include: Primary Brain Tumors : These originate within the brain itself or its immediate surroundings. Gliomas: The most common type, originating from glial cells. Subtypes include astrocytomas, oligodendrogliomas, and glioblastomas. Meningiomas: Arising from the meninges, the membranes surrounding the brain and spinal cord. Pituitary Adenomas: Tumors developing in the pituitary gland, affecting hormone production. Medullob
Read more

Cystic Fibrosis- causes and symptoms

-
Image
Introduction Cystic fibrosis (CF) is a hereditary disorder that primarily affects the lungs and digestive system. It is characterized by the production of abnormally thick and sticky mucus that can clog the airways and obstruct the pancreas. CF is a progressive disease, leading to severe respiratory and digestive problems, and it often results in a shortened lifespan. Causes Cystic fibrosis is caused by mutations in the CFTR (cystic fibrosis transmembrane conductance regulator) gene. This gene is responsible for the production of a protein that regulates the movement of salt and water in and out of cells. Mutations in the CFTR gene result in the production of a defective protein, leading to the accumulation of thick mucus in various organs. Symptoms The symptoms of cystic fibrosis can vary widely but commonly include: Respiratory symptoms: Persistent coughing, frequent lung infections (including pneumonia and bronchitis), wheezing, and shortness of breath. Digestive symptoms: Difficu
Read more