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    PPIUD

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    musicwizard
    The document discusses postpartum IUD insertion, including timing, advantages, and expulsion rates. It notes that PPIUD insertion within 10 minutes of placental delivery has the lowest expulsion rate of 3%, compared to 9.5% for immediate postpartum insertion and 37% for insertion within 48 hours postpartum. The document also outlines WHO categories for IUD use and notes that PPIUDs are generally safe and effective for birth spacing when inserted properly in the immediate postpartum period.

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    PPIUD

    Uploaded by

    musicwizard
    111 views16 pages
    The document discusses postpartum IUD insertion, including timing, advantages, and expulsion rates. It notes that PPIUD insertion within 10 minutes of placental delivery has the lowest expulsion rate of 3%, compared to 9.5% for immediate postpartum insertion and 37% for insertion within 48 hours postpartum. The document also outlines WHO categories for IUD use and notes that PPIUDs are generally safe and effective for birth spacing when inserted properly in the immediate postpartum period.

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    post partum IUD

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    The document discusses postpartum IUD insertion, including timing, advantages, and expulsion rates. It notes that PPIUD insertion within 10 minutes of placental delivery has the lowest expulsion rate of 3%, compared to 9.5% for immediate postpartum insertion and 37% for insertion within 48 hours postpartum. The document also outlines WHO categories for IUD use and notes that PPIUDs are generally safe and effective for birth spacing when inserted properly in the immediate postpartum period.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    111 views16 pages

    PPIUD

    Uploaded by

    musicwizard
    The document discusses postpartum IUD insertion, including timing, advantages, and expulsion rates. It notes that PPIUD insertion within 10 minutes of placental delivery has the lowest expulsion rate of 3%, compared to 9.5% for immediate postpartum insertion and 37% for insertion within 48 hours postpartum. The document also outlines WHO categories for IUD use and notes that PPIUDs are generally safe and effective for birth spacing when inserted properly in the immediate postpartum period.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 16

    Postpartum IUD (PPIUD)

    Intrauterine Device (IUD)

    Other IUDs
    Frameless GyneFix Consists of several copper cylinders tied together on a string Anchored 1 cm deep into the fundus of the uterus Introduced in 1990s Newer: Fibroplant LNG with progestin

    Mechanism of Action
    Copper ions:
    Interferes with the ability of the sperm to pass through the uterine cavity Decreases sperm motility and function Alters the uterine and tubal environment

    IUDs: Who Should Not Use (WHO Category 4)


    IUDs should not be used if a woman has/is: Pregnant (known or suspected) Unexplained vaginal bleeding Current PID, gonorrhea or chlamydia Acute purulent discharge Immediate post-septic abortion Puerperal sepsis Known pelvic tuberculosis Malignant trophoblastic diisease Genital tract cancers (cervical or endometrial) Distorted uterine cavity (myoma uteri) Chorioamnionitis Unresolved postpartum hemorrhage

    IUDs: Conditions Requiring Precautions (WHO Category 3)

    IUDs are not recommended for insertion unless other methods are not available or acceptable: 48 hours to 4 weeks post-partum AIDS (but no antiretroviral therapy or no access to care) High individual risk of chlamydia or gonococcal infection (partner has current STI) Ovarian cancer Benign trophoblastic disease Systemic lupus erythematosus with severe thrombocytopenia Prolonged rupture of membranes (>18 hours)

    Advantages
    Highly effective (99.2 99.4%) safe Use and forget May be safely used by immediately postpartum and lactating women Long duration of use (12 years) but can be used as shorterterm method Allows privacy No systemic side effects Does not interact with medications client may be taking

    Timing of IUD Insertion


    Interval insertion
    Anytime during the menstrual bleeding Any other time within the menstrual cycle at the clients convenience, provided that it is reasonably certain that the woman is not pregnant
    8 weeks after Cesarian delivery

    Post-abortion
    Immediately after evacuation if no infection

    IUD Category

    M E T H O D S

    Reproductive Needs Short term Long term Permanent (<3 years) (>=3 years) Condom, FAB BTL, LAM, FAB methods, Vasectomy, methods, Pills, DMPA, DMPA, IUD Pills, DMPA, IUD IUD

    Conclusion
    Postpartum insertion of IUDs appears safe and effective Advantages: motivation, assurance that the woman is not pregnant and convenience Few medical reasons why the method should be withheld PPIUD expulsion rates higher than with interval insertion Popularity of PPIUD in China, Mexico and Egypt supports feasibility of approach Early follow-up important to identify spontaneous IUD expulsion

    Expulsion Rates

    TIMING OF INSERTION Interval (more than 4 weeks after delivery) Immediate Postpartum (within 10 minutes)

    EXPULSION RATE Low (3%)

    Slightly higher (9.5%)

    Early Postpartum (within 10 minutes and 48 hours)

    Moderately higher (37%)

    Expulsion Rate
    Studies show that for best results devices should be inserted within 10 minutes of placenta expulsion rather than at any other time before discharge from the hospital Emphasis needs to be given to the fundal placement of the device. The provider should be able to feel the device through the abdominal and uterine walls at the time of the insertion The arms of the T device may normally embed in the endometrium and submucosal layer for a few millimeters, thus enhancing the retention of the device

    Expulsion Rate (continuation)


    Because uterine contractions are stronger and more frequent in breastfeeding women, uterine involution after delivery is believed to be faster. This could possibly produce either higher expulsion rates (if IUDs were pushed out) or lower expulsion rates (if IUDs were held in) However, results from a study indicates that breastfeeding does not increase the risk of expulsion

    HIV/AIDS and Use of the IUD


    Use of the IUD:
    Does not increase risk of female acquisition of HIV Does not speed progression toward AIDS among HIV-infected users Does not increase risk of transmitting HIV to uninfected partner Does not increase the risk of PID or pelvic infection

    Women who are HIV-infected and clinically well, even if on ARVs, can use the IUD

    IUD and Ectopic Pregnancy

    IUDs are great protection against ectopic pregnancy because they are so effective at preventing pregnancy

    IUD and Anemia


    Monthly menstrual bleeding increases slightly with the IUD, especially in first 3 months Menstrual blood loss resulting in anemia is rare Therefore, it is safe to provide an anemic woman with an IUD If a woman is anemic and has the IUD to place, continue to treat anemia with iron/folate

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