SHORT ANSWER MANAGEMENT POP QUIZ:
SOGC guidelines recommend the timing of IUD insertion be at ____ weeks after delivery.
A patient with IUD presents with a positive pregnancy test. What's your next management step?
How does the copper IUD affect endometrial cancer risk?
List THREE required criteria for lactional amennorrhea to achieve maximum effectiveness
Here at The Review Course, we're busy reviewing new guidelines so you don't have to!
Below are four pearls from the SOGC's new Canadian Contraception Consensus so you can make sure you are suggesting the latest, guideline-based care! We'll follow up soon with three more notes on current Canadian contraceptive guidelines.
1. Consider immediate postpartum IUD insertion. This is associated with higher continuation rates, but also higher expulsion rates, compared to traditional 6 week insertion.
2. If a patient has a pregnancy with IUD in place, remove the IUD immediately if you can see the strings; this decreases adverse pregnancy outcomes. Don't delay; the strings may not be visible tomorrow, and hysteroscopic removal is much riskier to the pregnancy!
3. Use of ANY IUD reduces lifetime endometrial cancer risk; yes, this includes copper!
4. Lactational amenorrhea is 98% effective for contraception as long as 3 key criteria are met: the woman is under 6 months postpartum, exclusively breastfeeding without baby sleeping through the night, and amenorrheic.