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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)

Perforations

Very rare (1 in 1,000 Insertions)

Risk:

  • Linked to skill and experience of provider

  • Reduced through supervised training

  • Greater for postpartum insertions performed between 48 hours and 4 weeks after delivery

Slide 16


Although rare, the woman’s uterus or cervix can be perforated when an IUD is inserted. When perforation occurs, it is a potentially serious event. According to the World Health Organization, rates of perforation at the time of insertion are generally 1 in 1,000. Perforation of the uterus after IUD insertion is also very rare.

The risk of perforation is directly linked to the skill and experience of the provider. Thus, the World Health Organization recommends that, whenever possible, providers perform at least 50 to 60 pelvic examinations and 10 to 15 IUD insertions under supervision before inserting an IUD without supervision. Carefully following the instructions for IUD insertion will also reduce the risk of a perforated uterus.

The risk of perforation is greater for postpartum insertions performed between 48 hours and four weeks after delivery, as the uterus returns to its normal size. For this reason, it is recommended that postpartum insertions be done within the first 48 hours after delivery or after four weeks.

 

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