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Managing Potential IUD Complications

Learn about possible complications of IUD insertion, such as vagal reactions, perforation, and infection. Understand when immediate action is needed and how to address each issue, including prophylaxis and treatment. Stay informed to ensure safe IUD use.

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Managing Potential IUD Complications

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  1. Potential complications • Vagal reactions • Mild: diaphoresis, nausea • Moderate: dizzy, lightheaded, low HR +/- BP • Severe: loss of consciousness, seizure • Perforation at time of insertion • By sound or IUD • Infection • Greatest in first 20 days (consider prophylaxis) • Expulsion • 2-5% in first year of use

  2. Vagal reactions • No need to do anything – they resolve without sequelae • Atropine 0.6mg IV works like magic

  3. Perforation at time of insertion • If you take the IUD out, expect rapid healing without sequelae • Copper IUDs in the abdominal cavity cause scarring and should be removed laparoscopically

  4. Infection • Consider prophylaxis in high risk women (metronidazole 2 g or doxycycline 300 mg) • Consider treatment does (one week of doxycycline) in very high risk women

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