Thursday, 27 October 2016

Failure of 'Copper-T' Resulting in Unwanted Pregnancy


Failure of 'Copper-T' Resulting in Unwanted Pregnancy

Every birth control measure (Contraceptive method) has its own failure rates which results in pregnancy. Intra Uterine Devices- IUD,( IUCD- Intra Uterine Contraceptive Device) which is known as ‘ Copper –T’  in layman’s language also has its failures.

                                                           

Presenting features of pregnancy with Copper-T in situ
-Woman will complain of missed periods
-Her pregnancy test will be positive
-Sonography will show presence of contraceptive device with pregnancy side by side

Fate of pregnancy with IUCD in situ ( IUCD-Intra Uterine Contraceptive Device )
-If the woman conceives with IUCD still inside uterus, the pregnancy in question may have higher chances of complications.
Infection ( Chorioamnionitis ) – The bag of membranes which surround the fetus become infected.  This is a serious medical condition as advance stage which is known as Sepsis, may involve infection in blood . This wide spread infection may become life threatening
Management
Involves- termination of pregnancy as soon as possible along with adequate cover with antibiotics.

Abortion
-There are higher chances of abortions whether spontaneous or induced. Here we should understand the woman opted for an IUD as she did not want to become pregnant any more.
-There is a rule by Government  of India under MTP act (Medical Termination of Pregnancy ) , that says that pregnant woman can seek termination of pregnancy ( in layman’s language-abortion ) upto  20 weeks if the said pregnancy has occurred as a result of failure of contraceptive ( Birth Control ) measure

Preterm Birth
Pregnancy with Copper –T in situ has a higher chance of preterm birth. Preterm birth has its own set of complications like low weight of neonate, requirement of NICU- Neonatal Intensive Care Unit, failure to thrive etc.

Ectopic Pregnancy
-If a woman conceives with ‘ Copper-T’ in situ, there are higher chances that the site of pregnancy will be abnormal.
-The normal site of implantation of pregnancy is inside the uterus.
-In ectopic pregnancy, the site of implantation can be Fallopian tubes (Tube like structure which is a passage between uterus and ovary), Ovaries etc.
-This pregnancy in abnormal location does not grow normally

                                                      


Management

-Early diagnosis by sonography and surgical intervention to remove this abnormally located pregnancy is required in most of the cases

What can be done once pregnancy is diagnosed with Copper –T inside uterus
-If thread is visible, which may be the case in early pregnancy, the treating Gynaecologist will gently pull on the thread to attempt removal. Many a times it is successful.
-Assistance of Ultrasound may be sought to make the removal procedure safe and easy.
If thread is not visible- termination of pregnancy by D&E- Dilatation and Evacuation may be offered along with the removal of Copper-T at the time of the procedure

By
My Gynaec World
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