Characteristics of an ideal candidate for Copper – T inseion include all of the following except :
Correct Answer: Has a history of ectopic pregnancy
Description: Ans. is c i.e. Has history of ectopic pregnancy The planned parenthood federation of America has described Ideal IUCD candidate as a woman. Who has no history of pelvic disease. Who has born at least one child Has normal menstrual periods Is willing to check IUCD tail Has access to follow up and t/t of potential problems Is in a monogamous relationship. Also know : Absolute contraindication of lUCD : Please Don't Ever Put Condom Pregnancy - Suspected / confirmed. DUB H/O ectopic pregnancy (Friends here I want you to know that according to Newer criteria a woman with a previous ectopic pregnancy can use IUCD.' PID (untreated acute cervicitis, vaginitis including bacterial vaginosis until infection is controlled) Cancer cervix. Mnemonic - Please Don't ever put condom. Relative contra indication are : Anaemiadeg Menorrhagiadeg Purulent cervical dischargedeg Distoions of the uterine cavity due to congenital malformations, fibroidsdeg Unmotivated persondeg Postpaum endometritis or infective aboion in the past 3 months. Multiple sex paners of woman or her husband. Genital actinomycosis. Extra Edge : Some impoant points from 'Leon Speroff' on patient selection for IUD. Age and parity are not critical factors in selection, the risk factors for STI's are the most impoant considerations Contraception of choice in patients with current recent or recurrent PID is Hormonal or Barrier method: Patients with heavy menstrual periods should be cautioned regarding the increase in menstrual bleeding associated with copper IUD. Women who are anticoagulated or have bleeding disorder are obviously not good candidates for copper IUCD, but might benefit from progestin IUCD. - Women who have abnormalities of uterus like bicornuate uterus are not good candidates for IUD inseion.deg - Patients with Wilson disease are not recommended copper containing IUCD as contraceptive - Immunosuppressed individuals should not use IUCD. Patients at risk for endocarditis should be treated with prophylactic antibiotics at the inseion and removal of IUCD. According to Speroff : cervical dysplasias are not contraindication for use of IUCD'sdeg but in patients with cervical stenosis it may be difficult to inse IUCD. No increase in adverse events has been observed with copper containing IUCD in women with either insulin dependent or non insulin dependent diabetes. Intact Cu containing IUCD's can be the ideal choice for a woman with diabetes especially if vascular disease is present.
Category:
Gynaecology & Obstetrics
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