Absolute contraindication for CuT inseion?
**Core Concept**
The question is testing the knowledge of absolute contraindications for the insertion of a Copper-T (CuT) intrauterine device (IUD), which is a type of long-acting reversible contraceptive method. The correct answer requires an understanding of the contraindications that make the insertion of a CuT IUD unsafe for a patient.
**Why the Correct Answer is Right**
The correct answer is an **active pelvic inflammatory disease (PID)**. This is because CuT IUD insertion can exacerbate an existing PID, leading to increased risk of infertility, chronic pelvic pain, and ectopic pregnancy. The insertion process involves the insertion of a foreign body into the uterus, which can cause bacterial migration and worsen the infection. Additionally, the copper ions released from the IUD can also contribute to the inflammation.
**Why Each Wrong Option is Incorrect**
* **Option A:** Nulliparity is not an absolute contraindication for CuT IUD insertion. In fact, nulliparous women can still benefit from the use of a CuT IUD.
* **Option B:** Previous cesarean section is not an absolute contraindication for CuT IUD insertion. However, the insertion process may require some modifications to accommodate the uterine scar.
* **Option C:** Previous ectopic pregnancy is not an absolute contraindication for CuT IUD insertion. In fact, a history of ectopic pregnancy is not a contraindication for the use of a CuT IUD.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that a patient with a history of PID or current symptoms suggestive of PID should not undergo CuT IUD insertion until the infection is fully treated and resolved.
**Correct Answer:** D. Active pelvic inflammatory disease (PID).