What are the CNGOF guidelines on intrauterine devices (IUDs)?

Updated: Nov 29, 2018
  • Author: Sarah Hagood Milton, MD; Chief Editor: Christine Isaacs, MD  more...
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Answer

Answer

Clinical guidelines on intrauterine contraception were released on November 11, 2018, by the Collège national des gynécologues et obstétriciens français (CNGOF) [67]

  • Intrauterine contraception (IUC) is indicated for adolescents, nulliparous, and patients living with HIV.
  • Women with IUC should not alter cervical cancer screening.
  • A bimanual examination and cervix inspection are mandatory before the device is inserted.
  • Systematic screening for sexually transmitted infection (STI) before device insertion is not recommended. STI screening should be completed before insertion but can also take place at the time of device insertion in asymptomatic women.
  • Before device insertion routine antibiotic prophylaxis and premedication are not recommended. 
  • Following device insertion, routine pelvic ultrasound examination is not recommended.
  • Radiological workup to locate the device is recommended in cases of suspected uterine perforation.
  • Intrauterine device should be laparoscopically removed from the abdominal cavity.
  • Exclude ectopic pregnancy in cases of accidental pregnancy with IUC.
  • In cases of STI or pelvic inflammatory disease, immediate removal of the device is not recommended.
  • Device removal should be considered in the absence of clinical improvement after 48 to 72 hours of appropriate treatment.

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