Follow-up after insertion of an IUCD
Routine follow-up
- at 3-6 weeks to check threads and exclude perforation
- return if problems or time for removal; no further follow-up needed
At first follow-up visit exclude infection, perforation or expulsion
Intrauterine device (IUD) only: For heavier and/or prolonged bleeding associated with use of an IUD:
- treat with non-steroidal anti-inflammatory drugs and tranexamic acid
- or suggest changing to the IUS if the woman finds bleeding unacceptable
If Actinomyces-like organisms are seen on a cervical smear, assess for pelvic infection, and remove the IUD or intrauterine system (IUS) (Mirena coil) if there are signs of infection
If a woman becomes pregnant with an intrauterine pregnancy, advise removal of the IUD or IUS before 12 weeks' gestation, whether or not she intends to continue the pregnancy.
Note - in addition to seeking review if there are concerns when they check their threads, individuals should be advised to seek urgent review if they have: • Symptoms of pelvic infection (e.g. change in vaginal discharge, pelvic pain and intermenstrual/ post-coital bleeding)
• Concerns regarding their bleeding pattern
• A positive pregnancy test.
Reference
- NICE. Long-acting reversible contraception. Clinical guideline CG30. Published October 2005, last updated July 2019
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