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Intrauterine Devices (IUDs)
Introduction Contents Post-Test References Go To Presenter Info

Goals

Section 1

- Introduction
- Objectives
- IUD/IUCD Use
- Safety
- Overview
- Early IUDs
- Copper IUDs
- Mechanisms
- Failure Rates
- Comparison
- Method Costs
- Characteristics
- Characteristics
- PID
- Incidence Rate
> Reducing Risk
- Perforations
- Ectopic
- Expulsions
- Rates

Section 2
Section 3

Summary

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Section 1 - Intrauterine Devices (IUDs)

Reducing the Risk of PID

  • Screen women for risk of STIs:
       - generally can use if at risk of STIs
       - not recommended if at high individual risk of      STIs
  • Screen out women with clinical symptoms and signs of an STI
  • Counsel about risk of PID
  • Follow infection prevention procedures during insertion
  • Recommend one-month follow-up visit to check for infection
       - return immediately if any symptoms of PID      develop

Slide 15


An IUD user's risk for developing PID can be reduced even further if providers follow important guidelines. First, screen women for risk of STIs. While women at risk of STIs can generally use an IUD, more careful follow-up after insertion may be recommended. However, providers should try to screen out women at high individual risk of STIs. This category of women may include, for example, those with more than one sexual partner, those whose partner has multiple sex partners, or those whose partners have symptoms of STIs.

Second, carefully screen women for any symptoms and signs of current STIs. In many cases, good clinical judgment is sufficient to rule out an infection with gonorrhea and chlamydia.

Ruling out the possibility of a current STI by medical history and physical examination is essential prior to providing the IUD. Laboratory tests are not required prior to IUD insertion, but they could be offered when available and when the provider has difficulties ruling out an infection by clinical judgment alone.

IUDs should never be inserted in women with current STIs. Women at high individual risk of STIs should generally not have an IUD inserted unless other methods are unavailable or unacceptable to the client and careful follow-up is possible.

Third, counsel all users about the risks of PID. Emphasize that behaviors that place the woman at greater risk for STIs also increase her risk of PID. Fourth, strictly follow infection prevention procedures to reduce the risk of introducing bacteria into the uterus. Fifth, most service delivery guidelines recommend that the client return about 30 days after the IUD is inserted to check for the presence of infection.Advise her to return immediately if she experiences symptoms such as fever or low abdominal pain during the first month after insertion.

 

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