IUD (Intra Uterine Device)

An intrauterine device, also known as intrauterine contraceptive device or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting reversible birth control.

1. INSERTION AND REMOVAL OF I.U.D PRESENTED BY- SANDHYA KUMARI M.Sc NURSING AMITY UNIVERSITY

2. Introduction of Intra Uterine Device An intrauterine device (IUD), also known as intrauterine contraceptive device (IUCD or ICD) or coil, is a small, often T-shaped birth control device that is inserted into the uterus to prevent pregnancy. IUDs are one form of long-acting reversible birth control (LARC).  

3. Mechanism of Action Copper-bearing IUDs is the prevention of fertilization. The presence of the IUD in the uterine cavity creates a local inflammatory reaction that appears to prevent sperm from reaching the fallopian tubes.

4. Types of IUD’s   1. Non-medicated IUD’s: Contraceptive action by producing sterile inflammatory response in Endometrium . These are available in ring shaped IUD’s made up of s.s and plastic fabricated form polyethylene, polypropylene.   2. Medicated IUD’s: - Copper IUD’s - Progesterone releasing IUD’s    

5. Copper bearing IUD’s 7-Shaped IUD: - Further development of the concept of intra-uterine contraception by metallic copper has resulted in copper barring IUD, which contains 89mg copper wire, wound around the vertical limb of a 7-shaped polypropylene device, to give an effective surface of approximately 200mm2 used for 3years as intra-uterine contraceptive treatment. • This device release copper ion at a mean daily dose of 9.87µg/day continuously in the uterine cavity for up to 40months. • The Cu-7 appears to be substantially smaller then other. • It can be easily inserted because of it’s special 7-configuration in addition to its small size. • Insertion can usually be accomplished without the need for cervical dilation and further more removal is generally painless.

6. CONTD- T-Shaped IUD’s: T-shaped IUD containing 200mm2 contraceptive copper wire winding around the vertical leg of a T-shaped polyethylene device in the manner as copper-7 device. • It is used for 3years of contraceptive treatment. • This T-shaped device has a volume of 0.16cm3,which is almost twice as large as the 7-shaped device. New development of copper bearing IUD’s: The Cu-T-380A with 2 collars of copper positioned on the transverse arms of the letter T. Each collar provides an additional surface area of 30mm2. It has relatively small surface area of copper but effective than Cu-T-200.  

7. MECHANISM OF ANTIFERTILITY ACTION OF COPPER • Copper is known to be cytotoxic in high concentration it enhances the spermatocidal and spermato depressive action of an IUD. • The copper concentration in endometrial epithelium and superficial stromata inhibits the binding of steroids of their receptors. • Cupric ion inhibits the binding of 17-β- estradiol to human endometrial cytosol . • Cupric ions shows only little effect on sperm motility. • Copper wire was also “ Blastocystocidal ”.

8. Insertion Procedure The Doctor uses proper infection-prevention procedures. IUD instruments. The Doctor conducts a pelvic examination to determine the position of the uterus and assess eligibility. The Doctor first does the bimanual examination and then inserts a speculum into the vagina to inspect the cervix. The Doctor cleans the cervix and vagina with appropriate antiseptic. The Doctor slowly inserts the tenaculum through the speculum and closes the tenaculum just enough to gently hold the cervix and uterus steady. The Doctor slowly and gently passes the uterine sound through the cervix to measure the depth and position of the uterus.

9. CONTD The Doctor loads the IUD into the inserter while both are still in the unopened sterile package. The provider slowly and gently inserts the IUD into the uterus and removes the inserter. The provider cuts the strings on the IUD, leaving about 3 centimeters hanging out of the cervix. After the insertion, the Client rests. She remains on the examination table until she feels ready to get dressed.

10. IUD Removal Procedure The provider inserts a speculum to see the cervix and IUD strings and carefully cleans the cervix and vagina with an antiseptic solution, such as iodine. The provider asks the woman to take slow, deep breaths and to relax. The woman should say if she feels pain during the procedure. Using narrow forceps, the provider pulls the IUD strings slowly and gently until the IUD comes completely out of the cervix.

11. Advantages of Intra uterine Devices Provides long-term birth control. Cost effective. Can be removed when a woman would like to become pregnant. Convenient - a woman does not need to remember it daily or weekly.  

12. Disadvantages of Intra uterine Devices Between 2 and 10% fall out, most commonly in the first year of use. Increased risk of miscarriage if an IUD is left in the uterus during pregnancy. In rare cases, the IUD may attach to or perforate the wall of the uterus. With the copper IUD, a woman may experience heavier bleeding and cramping with periods.  

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