A lady with IUCD becomes pregnant with tail of IUCD being seen, next course of action is :
Ans. is b i.e. Remove the IUCD A woman with an IUCD in place, with amenorrhea should have a pregnancy test and pelvic examination. If an intrauterine pregnancy is diagnosed and IUCD strings are visible : IUCD should be removed as soon as possible in order to prevent later septic aboion, premature rupture of membranes and premature bih. If an intrauterine pregnancy is diagnosed and IUCD strings are not visible : An ultrasound examination should be performed to localize the IUCD and determine whether expulsion has occured. If the IUCD is present there are three options for management. Therapeutic aboion If IUCD is not fundal in location : ultrasound guided intrauterine removal of IUCD. If IUCD is present in fundus of uterus : it should be left in place and pregnancy continued with the device left in place. If pregnancy continues with the device in place, the patient should be warned of the symptoms of intrauterine infection like fever or flue like symptoms. abdominal cramping or bleeding. At the earliest sign of infection, high dose intravenous antibiotic therapy should be given and the pregnancy evacuated promptly. Also know : Method of removal of IUCD: If IUCD is in the uterine cavity : By Shirodkar hook or hysteroscope. If IUCD is embedded in myometrium . By Hysteroscopedeg. In case of perforation : Laparotomy is needed because CuT causes adhesions to the omentum or Gut and cannot be retrived through a laparoscope.
MTP
Remove the IUCD
Continue the pregnancy
Remove IUCD and terminate pregnancy