IUD placement

The intrauterine device (IUD) is the main method of family planning and birth control measures in China. Because of its simplicity, economy, safety and recyclability, it has been accepted by the majority of women in China. The variety of birth control devices is constantly updated. The aim is to find new safe and reliable methods for better contraceptive and lower side effects. Several intrauterine devices that are practical today in China are as follows. There are dozens of different types and initial intrauterine devices that are used worldwide. New intrauterine devices are being developed. Although they have different shapes, they can be roughly divided into two categories. 1. Inert intrauterine device is made of inert raw materials, such as metal, plastic, silica gel, nylon, etc. The pregnancy rate and the rate of de-ringing are high, and production stopped in 1993. 2. Active intrauterine device The second-generation IUD, which is widely used at home and abroad, contains active substances such as metals, hormones, drugs and magnetic substances. Domestic products include copper IUD and progesterone IUD. Treatment of diseases: uterine fluid Indication Any woman of childbearing age who requires an IUD without a contraindication can be placed. Contraindications 1. Severe systemic disease. 2. Acute and chronic genital tract inflammation. 3. Reproductive organ tumors. 4. Uterine malformations. 5. The cervix is too loose, severe old cervical laceration or uterine prolapse. 6. Menorrhagia, excessive frequency or irregular bleeding. Preoperative preparation 1. Preoperative examination Detailed medical history, last menstrual date and gynecological examination, laboratory test for vaginal trichomoniasis, fungus, vaginal cleanliness, if necessary, cervical scraping to check cancer cells. Anyone with trichomoniasis or fungi should be cured before placing. 2. Measure body temperature, pulse, and perform a full physical examination if necessary. 3. Time selection 1 month after clean 3~7d; 2 3 months after delivery, 6 months after cesarean section; 3 After artificial abortion, normal delivery placenta delivery, if there is no abnormality during cesarean section; 4 lactating amenorrhea should be placed after pregnancy; 5 After spontaneous abortion or mid-term pregnancy induction, it needs to be placed 3 to 7 days after the next menstrual period. 4. Instrument vaginal speculum, disinfection forceps, cervical forceps, uterus probe, cervical dilator 3 ~ 6 set, place the ring, take the ring, small curettes and other disinfection. 5. The disinfection metal of the IUD is boiled or autoclaved or soaked in 75% ethanol for 30 minutes. Plastic or nylon was immersed in 75% ethanol or 1:1000 negerin solution for 30 min. 6. Empty the bladder before surgery. Surgical procedure Take the copper T-type IUD as an example: 1. After emptying the bladder, take the bladder lithotomy position and routinely disinfect the vulva to wash the vagina. 2. Lay the sterile hole towel and arrange the instruments. 3. Vaginal PV examination confirmed the size, direction and double attachment of the uterus with or without inflammation and mass. 4. Put the vaginal device to expose the cervix, and rub the cervix and sputum with iodine. 5. Cervical clamps the anterior lip of the cervix to pull outward. If the uterus is excessively flexed, the uterus is horizontally pulled as far as possible. After measuring the depth of the uterine cavity with the uterus probe, the cervix is expanded to the extent of the cervix. number 6. 6. Place the tail wire and the solid rod in the placement tube, place the solid rod on the lower end of the T wire arm, and place the tail wire on the side of the solid rod. Fold the T cross arm so that both ends are inserted into the placement tube. The folding time is not exceeded. 5min to prevent deformation, the regulator is placed at the depth of the uterine cavity, and the direction of the long axis of the regulator is consistent with the direction of the T-cross arm. 7. The cervix is placed along the uterine cavity into the placement tube with T, keeping the plane of the regulator and the depth of the anterior and posterior wall of the uterus to contact the uterine fundus. At this point, the position of the regulator is about outside the cervix. The mouth is about 1cm. Fix the solid rod and withdraw the positioner by 1.2cm. At this time, the cross arm will stretch to the two sides to restore the horizontal position, then move the placement up to the lower end of the T cross arm and send T to the bottom of the palace. At this time, the regulator is just in the uterus. At the outer mouth, pull out the solid rod, then slowly withdraw the placement tube from the uterine cavity, and cut off the external tail wire to keep about 1.5cm. complication 1. Pain: Duodenal contraction often causes pain, especially when the selected IUD is too large or not placed in the fundus, the pain is strongly obvious, and a smaller model IUD should be removed or replaced. 2. Bleeding: A small amount of irregular bleeding after the device is caused by contact between the IUD and the uterine wall, causing uterine contraction, partial damage of the endometrium, no need to deal with. If the amount of bleeding is too large or the amount of menstruation is too much, and the bleeding time is long, you should be alert to the presence of infection. Remove the IUD if necessary and give anti-inflammatory treatment. 3. Infection: 2 to 3 days after surgery, the abdominal pain is gradually intensified, and the body temperature is elevated. There is bloody drainage in the vagina. After the diagnosis is confirmed, the IUD should be taken out and treated with anti-infection. Infections are often caused by improper handling or unsanitary care after placement, so the principle of sterility should be strictly observed during the operation. Once the infection is combined, anti-inflammatory treatment is actively administered. 4. Uterine wall injury: IUD causes damage to the uterine wall. It can be completely penetrated or partially invaded in the uterine wall. It occurs in the following situations: (1) The position and flexion of the uterus were not ascertained. (2) Operational rudeness: It occurs in the uterus during lactation, and the IUD is worn from the bottom of the palace, especially at the two corners. Once the diagnosis of IUD ectopic should be removed in time, according to the ectopic position through the abdomen or transvaginal removal. 5. IUD incarceration: If the IUD is too large and the fracture causes the IUD to be partially or completely embedded in the muscle wall, it should be removed in time. 6. De-ringing and belt pregnancy: It is related to the skill level of the surgeon, the size of the IUD and the materials produced. Subjects with loose uterine cervix, excessive physical exertion, excessive size, and menorrhagia after placement of IUD are also likely to cause IUD shedding. IUD is not placed at the end of the uterus or IUD is too small, located below or on one side of the uterine cavity, IUD ectopic and uterine malformation, lactation can lead to pregnancy. If you fall off or bring a pregnancy, you should be advised to switch to other methods of contraception.

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