Summary of consultation/procedure
Box 8: Summary of Intrauterine Contraception Consultation/procedure
Discuss all contraception options |
Medical eligibility |
For all IUC avoid
- 48h-4weeks postpartum
- Postpartum sepsis
- Unexplained vaginal bleeding
- Cervical cancer
|
- Distorted uterine cavity (inc large fibroids)
- Current PID/chlamydia/gonorrhoea/pelvic TB
- CD4 count <200
- Long QT syndrome
|
For LNG-IUS only avoid
- Breast cancer
- Severe liver disease
- Development of CVD/stroke while using
|
Discuss possible side effects |
- Altered bleeding (often persistent)
- Recurrent vaginal infections
- Headaches
|
- Acne
- Reduced libido
- Skin atrophy
|
Rule out pregnancy, consider chlamydia screening |
Explain procedure, including risks |
Consent |
Extra precautions needed |
None needed for Cu-IUC
For LNG-IUC
- If starting within 7 days of cycle none needed
- After 7 days, extra precautions for 7 days
- If switching from POP, CHC or Cu-IUC, extra precautions for 7 days*
|
Insert & document |
- Only trained professional to insert
- Pelvic examine & apply forceps
- Probe first, then insert/release coil
- Check canal and cut threads 2-3cm
- Document batch number and expiry date
|
Follow-up advice |
- Monitor threads
- Advise signs of infection/perforation/loss coil
- Offer follow-up at 6 weeks if woman wishes (sooner if concern)
- Date when IUC needs to be changed
|
*Up to day 7 only applies to true cycles. These rules do not apply for women on CHC. For women on CHC, 7 days extra precautions are needed if inserted from day 3 of HFI and during first week of taking CHC. If LNG-IUS inserted week 2 or 3 then no extra precautions needed
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