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Study of IUD insertions and clinical performance in nulliparous women Dr Andrea Brockmeyer Dr Meera Kishen Abacus Clinics Liverpool, UK.

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Presentation on theme: "Study of IUD insertions and clinical performance in nulliparous women Dr Andrea Brockmeyer Dr Meera Kishen Abacus Clinics Liverpool, UK."— Presentation transcript:

1 Study of IUD insertions and clinical performance in nulliparous women Dr Andrea Brockmeyer Dr Meera Kishen Abacus Clinics Liverpool, UK

2 Background b b Increased interest in IUDs from nulliparous women b b Proven efficacy and safety of standard IUDs b b No increased risk of PID in nulliparous women

3 Background No studies about b b acceptability b b removal rates for pain and bleeding b b rate of spontaneous expulsions in the standard IUDs and the IUS in nulliparous women in the UK

4 Objectives b b To assess experience of IUD/IUS fitting and use by nulliparous women (< 24 weeks)

5 Methodology b b Prospective pilot study b b Recruitment of 100 nulliparous women at Central Abacus b b Routine IUD/IUS insertions or IUD insertions for EC but long-term use b b Questionnaire at time of IUD/IUS insertion

6 Methodology b b Follow-up by postal questionnaire or contact by phone three months and one year after insertion

7 STI screening b b Sexual history b b CT/GC testing offered if appropriate b b Antibiotics (Azithromycin) offered if high risk of CT

8 Recruitment b b Recruitment from May-October 2005 b b Total recruited118 b b IUD/IUS fitted113 b b Available for follow-up112 b b Failed insertions 2 b b Other problems 4

9 Age range

10 Reasons for IUD/IUS fitting b b EC and long-term use30 (25.4%) b b Interval fitting88 (74.6%)

11 STI testing b CT test at fitting48 b CT test in current relationship65 b CT test declined 5 b Antibiotics given15 b No positive CT tests reported

12 Fitting procedure b b Local anaesthesia27 (24%) b b Difficulty sounding17 (15%) b b Use of dilators10 (9%) b b Problems10 (9%) Failed IUD insertion2 (1.8%) Client felt faint7 (6%)

13 Clinicians impression of fitting b b Easier than expected46 (41%) b b As expected56 (50%) b b Worse than expected 9 (8%)

14 Client’s impression of fitting

15 b b Less painful than expected37 (33%) b b As expected51 (45%) b b More painful than expected22 (19%)

16 Three-month follow-up (interim results) b b No of women contacted112 b b Questionnaire received72 (64.2%)

17 Problems b b No, not at all23 (32%) b b Yes49 (68%) b b Symptoms but not a problem 10

18 Abnormal bleeding b b Abnormal bleeding46 (63.8%) b b Periods heavier39 (54.1%) -Unable to cope 4 (5.5%) b b Intermenstrual bleeding21 (29.1%) b b Postcoital bleeding 5 (6.9%) b b Other 8 (11.1%)

19 Pain b b Pain45 (62.5%) b b Periods more painful35 (48.6%) b b Dyspareunia10 (13.8%) b b Other13 (18.0%) - pain between periods11 - constant pain 2

20 Pelvic infection   Pelvic infection1 (1.3%)

21 Have you still got your IUD/IUS in? b b Yes65 (58%) b b No 7 (6%) (+3 removed in 3/12) b b Expulsion3 b b Removal5 b b - Bleeding2 b b - Pain3

22 Satisfaction with IUD/IUS

23 Conclusion b b In general, IUD/IUS fittings well tolerated b b Majority of women satisfied with device b b NICE Guidance: All women should be given full choice of methods incl. IUD/IUS b b Numbers too small to compare devices


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