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Gynaecology & Obstetrics Contraceptives 7e4a4873

Characteristics of an ideal candidate for copper-T insertion include all of the following except

A
Has born at least one child
B
Is willing to check IUD tail
C
Has a history of ectopic pregnancy
D
Has normal menstrual periods
High-Yield Explanation
Ans. is c, i.e. Has history of ectopic pregnancyRef: Parks 20th/ed, p427The planned parenthood federation of America (PPFA) has described Ideal IUCD candidate as a woman.* Who has no history of pelvic disease.* Who has born at least one child* Has normal menstrual periods* Is willing to check IUCD tail* Has access to follow up and treatment of potential problems* Is in a monogamous relationship.Extra EdgeSome important points from 'Leon Speroff' on patient selection for IUD.* Age and parity are not critical factors in selection, the risk factors for STI's (sexually transmitted infection) are the most important considerations* Patients with heavy menstrual periods should be cautioned regarding the increase in menstrual bleeding associated with copper IUD. Women who are anticoagulated or have bleeding disorder are obviously not good candidates for copper IUCD, but might benefit from progestin IUCD.- Women who have abnormalities of uterus like bicornuate uterus are not good candidates for IUD insertion.Q- Patients with Wilson's disease are not recommended, copper containing IUCD as contraceptive- Immunosuppressed individuals should not use IUCD.* Patients at risk for endocarditis should be treated with prophylactic antibiotics at the insertion and removal of IUCD.* According to Speroff: cervical dysplasias are not contraindication for use of IUCD's Q but in patients with cervical stenosis it may be difficult to insert IUCD.* No increase in adverse events has been observed with copper containing IUCD in women with either insulin dependent or non-insulin dependent diabetes. In fact Cu containing IUCD's can be the ideal choice for a woman with diabetes especially if vascular disease is present.

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