The website is launched on 29 June 2018

Long Acting Reversible (LARCs)

Intra uterine devices (IUD or IUCD)

Ectopic Pregnancy

  • Absolute risk of Ectopic Pregnancy is REDUCED in IUCD users compared to Non users
  • NICE estimate 1 in 1000 at 5 years
  • However should a pregnancy occur in IUCD users, the likelihood of Ectopic is higher compared to Non Users
  • Data are insufficient to determine the different in Ectopic rate of LNG-IUS users vs Copper IUCD users
  • Possibility of Ectopic should be considered in IUCD users who are symptomatic and UPT positive.

Expulsion, Post Partum and Post Abortion insertion

  • Risk of Expulsion is 1 in 20 and is most common in the 1st year of use, particularly the first 3 months.
  • Immediate Post partum insertion is safe but may be associated with higher expulsion rate than interval insertion
  • Post Abortion insertion reduces the incidence of unwanted pregnancies and repeat abortion.
  • Post Abortion insertion is safe and practical but expulsion rate appears to be higher compared to interval insertion

Pelvic Inflammatory Disease & Perforation

  • PID appears to be linked to the insertion procedure and background risk of STIs
  • From review of randomised trials, there appears to be 6 fold increase risk of PID in the first 20 days, thereafter the risk remained low.
  • The overall risk of PID is low in IUCD users
  • The rate of uterine perforation is very low.
  • The rate is up to 2 per 1000 insertions and is approximately 6 fold higher in breastfeeding women.
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