Insertion technique for the Copper T380A IUD

Insertion technique for the Copper T380A IUD


IUD technology has come a long way since the
first plastic devices, such as the Lippes Loop, appeared on the scene in the 1960s.
Towards the end of that decade, it was discovered that adding copper to the plastic made the
IUD more effective in preventing pregnancy and caused bleeding problems to occur less
frequently. The first copper-bearing IUDs were produced
in the early 1970s, but they required replacement every 2 to 3 years. Further research at the
end of the 1970s produced IUDs with larger quantities of copper: among the better known
examples are TCu-380A, TCu-220C, and Multiload-375. These devices not only reduced the incidence
of side-effects compared with previous IUDs, but also had significantly longer life spans
and lower failure rates. This video demonstrates the insertion technique
for the TCu-380A IUD, which has been shown in a Cochrane review to be more effective
than other IUDs. Have ready, in an easy-to-reach position,
a vaginal speculum, the IUD to be inserted and the applicator on a sterile surface. Ensure that the woman is in a comfortable
position. You should have already explained the procedure to the woman and responded to
her questions and concerns. This helps the woman to relax, making insertion
easier and less painful. Perform a pelvic examination to rule out genital
tract infections or abnormalities as well as to ascertain the position of the uterus.
You will need to follow appropriate infection-prevention procedures, including the use of sterile instruments
and cleaning of the cervix with a water-based antiseptic such as chlorhexidene. Insert the speculum into the vagina to have
a clear view of the cervix. Cleanse the surface of the cervix with an antiseptic swab. Grasp the upper lip of the cervix with a tenaculum
forceps to allow, if needed, application of gentle traction to straighten the angle between
the cervical canal and uterine cavity. Assess the angle of the cervical passage and
depth of the uterine cavity by gently inserting a uterine sound through the cervix until you
feel the sound has touched the fundus. Note the depth of the uterus by counting the
number of notches on the sound visible from the cervix. The TCu-380A IUD comes with its inserter in
sterile packaging. Using the “no-touch technique”, load the IUD into the inserter while both
the IUD and the inserter are still in the package. Here is how it is done. Pull back
the inserter tube to let the IUD lie freely in the loading capsule. Then, by squeezing
on the sides of the loading capsule, bring the horizontal arms of the IUD close to its
vertical body. Now push the inserter tube forward to capture
the body and the two arms of the IUD in the inserter tube. Once the IUD is captured, it should be inserted
into the uterus within a few minutes. Push the blue flange on the inserter tube to a
point that corresponds to the depth of the uterus you had measured with the sound. Remove
the loading capsule, but maintain traction on the two strings at the lower end of the
IUD to keep the device in position. Introduce the plunger into the inserter tube until it
reaches the lower end of the IUD. Holding the tenaculum forceps with one hand
to ease passage for the inserter tube, introduce the loaded inserter tube into the cervical
canal until the blue flange reaches the mouth of the cervix. Holding the plunger steady,
pull back the inserter tube a couple of centimeters to release the arms of the IUD inside the
uterus. Then, first remove the plunger and then the inserter tube. The final step in the procedure is to cut
the synthetic threads to about 2 cm from the cervix.

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