Journal Reading

An unusual cause of dyspareunia: secondary cervical perfo

ration by post placental intrauterine contraceptive device
International Journal of Reproduction, Contraception, Obstetrics and Gynecolog
y Chauhan M et al. Int J Reprod Contracept Obstet Gynecol. 2015 Jun;4(3):881-
883

Oleh dr...........................
Introduction

In India, 65% of women in the first year postpartum have an

High Prevalence unmet need for family planning and 61% of births occur at s
horter interval of recommended birth to birth interval

Postpartum contraceptive insertion technique it

Long term contraception has shown good efficacy with minimal complicati
ons

Menstrual irregularity, dysmenorrhea, sponta

Symptoms neous expulsion, device misplaced causing dys
pareunia.

Secondary cervical perforation due to

Case Report copper T 380 A as cause of dyspareunia
 24 Years old primiparous woman comes
with dyspareunia and pain on squatting
Case Report for last 3 month

3
 History

24 y o primiparous woman h
ad an uneventful vaginal deli No symptoms and normal finding
very s

Tertiary care hospital Routine f.u visit

6 month ago 4.5 months ago

Within 10 minutes after pl 3 months ago

acental delivery

She had a Cu T 380A inse She resuming coitus and started e

rtion xperiencing distressing dyspareuni
a and pain on squatting

4
 History
She reported to Gynecology OPD and wa
Speculum examnination: IUD thread was seen coming
s examined by a resident. Menstrual co
mplaint (-), cu t thread was seen coming t to cervical os, knob of the copper covered vertical limb
o cervical os. was seen peeing through posterior aspect of the cervix

Tertiary care hospital Tertiary care hospital

3 months ago 2.5 months ago

3 months ago (cont) 2.5 months ago (conth)

She was advised antibioti IUD removal

cs and OAINS Bleeding (-)
Patient was sent home at same da
y
5
Figure 1: Secondary cervical perforation by postplacen
tal intrauterine device.
 Figure 1: Secondary cervical perforation by post
Figure 2: placental
Removal of Copper T
intrauterine device. by holding
the knob of vertical limb.
 DISCUSSION
Dispareunia following child birth

ti
ov
l
ty ca

n ns

n
on tr
i e gy

i
tio Co

Pa
si e
er e R
nx lo
)

pa ic

al
(a ho

r in
PI

on

e
yc

rin
te

hr
Ps

Pe
U

C
Problems associated with intrauterine contraceptive device:
Menstrual irregularity
Displacement (usually correlated with a missing thread)

8
 Discussion

Case: chance of ontraceptive fail

ure leading to unwanted pregnan Follow up and promp managem
cy ent of IUD complications

Case: cervical perforatio

Secondary cervical perforation o
n f intrauterine device has been re
ported in the literature,.

Case: Thread was seen t

In almost all cases, it is mandato
hrough the os ry to do an inspection of fornice
s to exlude perforated device

The Power of PowerPoint | thepopp.com 9

 Woman attending for postpartum Cop
per T checkup with symptoms should
be critically evaluated
The success of postpartum copper T in
Conclusion trauterine insertion hinges on strict ad
herence to the rule involved patient se
lection, follow up and prompt complic
ation management.

The Power of PowerPoint | thepopp.com 10

Thank You