Question
Which of the following is not a contraindication for intrauterine device (IUD) insertion?
| A. |
Suspected pregnancy |
| B. |
Trophoblastic disease |
| C. |
Severe dysmenorrhea |
| D. |
During cesarean section |
|
Correct Answer » D Explanation |
 |
Clinical Reasoning for the Correct Answer:
– IUD insertion during cesarean section is considered safe and is a recommended postpartum contraception method.
– Immediate postplacental insertion (within 10 minutes after placental delivery in cesarean section) minimizes the risk of perforation and ensures high efficacy.
Why Option A is Incorrect:
– Suspected pregnancy is a strict contraindication to IUD insertion.
– Risk: IUD insertion can harm an established pregnancy or result in miscarriage.
Why Option B is Incorrect:
– Trophoblastic disease (e.g., gestational trophoblastic neoplasia) is a contraindication due to risk of uterine perforation, heavy bleeding, and infection.
Why Option C is Incorrect:
– Severe dysmenorrhea, especially with copper IUDs, is a relative contraindication.
– Copper IUDs can worsen menstrual cramping and bleeding.
– While not an absolute contraindication, severe dysmenorrhea usually precludes copper IUD, but not necessarily levonorgestrel IUDs.
Why Option D is Correct:
– Placement of an IUD during cesarean section is commonly performed (postplacental IUD insertion).
– No increased risk versus interval placement; often done for convenience and reliability.
High‑Yield Synopsis:
IUD Contraindications
– Absolute: Pregnancy, active pelvic infection, unexplained vaginal bleeding, known/suspected malignancy of genital tract, current gestational trophoblastic disease.
– Relative: Severe anemia, severe dysmenorrhea, distortion of uterine cavity.
IUD Insertion Timing
– Postpartum: Can be inserted during cesarean or within 10 minutes post-placenta delivery.
– Interval: Any time if pregnancy is reasonably excluded.
