Intrauterine Contraceptive Device Insertion

Description

Placement of an intrauterine contraceptive device (IUD).

Indications

Elective, desiring contraception. The IUD is associated with an efficacy rate that is comparable to sterilization and oral contraceptives and may be a particularly good choice for women with diabetes, thromboembolism, menorrhagia, or dysmenorrhea. The copper IUD may be preferable for those breastfeeding or with breast cancer or liver disease. The copper IUD may be placed up to 5 days after unprotected intercourse as an emergency contraceptive measure. The progestin-releasing IUDs may be used as a treatment for menorrhagia in select patients.

Contraindications

Active cervical infection, acute sexually transmitted disease, allergy to any component of the device, dysfunctional uterine bleeding (undiagnosed), genital actinomycoses, history of ectopic pregnancy (relative), immunocompromised (relative), IUD in situ (unremoved), malignancy (uterine or cervical, known or suspected), multiple sexual partners (relative), pelvic inflammatory disease (current or past 3 months), pregnancy (known or suspected), uterine cavity malformation, vaginitis, Wilson disease (hypothetical, copper IUD only).

Required Equipment

• Intrauterine contraceptive device in sterile package

• Skin (vaginal) preparation materials (iodine-based antibacterial solution or other suitable cleansing agents)

• Vaginal speculum

• Tenaculum

• Scissor (long)

• Uterine sound (optional)

• Nonsterile examination gloves

• Sterile gloves (optional with “no touch” technique)