Devices Kamal Kumar Gupta Intrauterine Devices An intrauterine device IUD is a small object made of polyethylene or other polymers that is inserted by a healthcare professional into the cavity of the uterus ID: 911571
Download Presentation The PPT/PDF document "Contraceptives Intrauterine" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
ContraceptivesIntrauterine Devices
Kamal Kumar Gupta
Slide2Slide3Intrauterine Devices
An intrauterine device (IUD) is a small object made of polyethylene or other polymers that is inserted by a health-care professional into the cavity of the uterus
IUDs prevent fertilization from taking place by blocking sperm from entering the uterine tubes.
Copper T 380A®, which is approved for up to 10 years of use and has long-term effectiveness comparable to that of tubal ligation
Some women cannot use IUDs because of expulsion, bleeding, or discomfort.
Slide4IUD
Non-medicated: First generation IUD,
Lippes
loop
Medicated: Second generation IUD, Copper IUD
Medicated: Third generation IUD, hormone-releasing IUD
Slide5First generation IUD
Inert or
nonmedicated
devices, usually made up of polyethylene or other polymers
Different shapes and sizes-loops, spirals, coils, rings and bows
Lippes
loops are commonly used in developing countries
Slide6Lippes loop
Double S shaped made of polyethylene
Nontoxic, non-tissue reactive and extremely durable
Contains small amount of barium
sulphate
for X ray observation
Attached thread or tail made up of nylon which project in the vagina after insertion
Tail can be felt to ensure that loop is at place
Four sizes A, B, C, D; larger size have greater anti-fertility effect and lower expulsion rate but higher removal rate because of pain and bleeding
Slide7Slide8Second generation IUD
Copper containing IUD, have strong anti-fertility effect
Smaller in size therefore easy to fit
Copper-7
Copper T-200
Copper T-220C
Copper T-380A or Ag
Multiload
devices such as ML-Cu-250
The number indicates surface area of the copper on the device Cu T-380 Ag indicates silver core over which copper wire is wrapped
Multiload
devices are effective
upto
five years
Slide9Copper T intrauterine device (IUD)
This IUD is a small device that is shaped in the form of a “T.” Doctor places it inside the uterus to prevent pregnancy. It can stay in uterus for up to 10 years. Typical use failure rate: 0.8%.
Slide10Intrauterine device (IUD)
Copper containing
Small flexible plastic device containing copper sleeves or wire that is inserted into the uterus
Copper component damages sperm and prevents it from meeting the egg
>99%
Longer and heavier periods during first months of use are common but not harmful; can also be used as emergency contraception
Slide11Slide12Slide13Advantages of copper devices
Low expulsion rate
Low side effects-pain and bleeding
Easy to fit in
Increased contraceptive effectiveness
Effective as post coital contraceptive, if inserted within 3-5 days of unprotected intercourse
Slide14Third generation IUD
Hormone releasing IUD
Progestasert
: T shaped device filled with 38 mg of progesterone,
releare
in the uterus@65mcg/day
It effect uterine lining, cervical
mucusand
sperm
LNG-20,
Mirena
: T shaped releasing 20mcg of
levonorgestrel
Low pregnancy rate
Slide15Intrauterine device (IUD) levonorgestrel
A T-shaped plastic device inserted into the uterus that steadily releases small amounts of
levonorgestrel
each day
Thickens cervical mucous to block sperm and egg from meeting
>99%
Decreases amount of blood lost with menstruation over time
Effective life 10 years
Slide16Slide17Mechanism of action of IUD
Causes a foreign body reaction in uterus resulting in cellular and biochemical changes in the
endometrium
and uterine fluids
Reduces viability of gamete and reduces chances of fertilization
Copper in Cu IUD also alter composition of cervical mucus may effect sperm motility
capacitation
and survival
Hormone releasing IUD increase the viscosity of cervical mucus and thus prevent the entry of sperm in the cervix
They make
endometrium
unfavourable
for implantation
Slide18Change of IUD
Inert IUDs such as
Lippes
loop can be left as long as they are required
Cu IUD need to be released due to corrosion and mineral deposition on Cu
Same way hormone releasing IUD needs to be changed as the stored hormone may get exhausted
Slide19Advantages
Simplicity: simple insertion process, no hospitalization
Can stay in place as long as required
Inexpensive
Reversible
Slide20Ideal IUD candidate
Has given birth to at least one child
No history of pelvic disease
Normal menstrual period
Willling
to check IUD tail
Has access to follow up
Slide21Timing of insetion
Most preferred time is during menstruation or within 10 days as during this time diameter of cervical canal is more so insertion is easy
First week after pregnancy- chances of expulsion and perforation are high, convenient time 6-8 weeks after pregnancy
Slide22Side effects
Bleeding : greater volume and longer menstrual periods
Pain
Pelvic infection: Pelvic inflammatory disease(PID)
Uterine perforation
Pregnancy
Ectopic pregnancy
Expulsion
Slide23