Mirena can’t have an IUD

I found it hard to remember the absolute contraindications to having an IUD or an IUS. Other than being male. So I came up with a rather gruesome story to remember it.

Mirena Wilson is pregnant. She goes to have an antenatal check up because she was very sick after her previous baby, and she’s recently started bleeding¬†which she doesn’t understand. Unfortunately she’s so septic that the infection has spread into her pelvis and through her cervix, and now her baby has been infected, and so she undergoes a septic abortion. While investigating her the doctor finds that she has four simultaneous cancers, which he’s never seen all together before:

  • Gestational trophoblastic neoplasia
  • Cervical cancer
  • Endometrial cancer
  • Breast cancer

She says she knew about the cervical cancer and was waiting to have treatment, but the other things she’s very surprised by, because she thought they were just fibroids. The doctor explains that the infection was TB, also says she has a strangely shaped uterus so she slaps him.

Absolute contraindications to IUD/IUS:

  • Pregnancy
  • Puerperal Sepsis
  • Septic abortion
  • Gestational Trophoblastic Neoplasia
  • Unexplained PV bleed
  • Cervical Cancer awaiting treatment
  • Endometrial cancer
  • Uterine fibroids
  • PID or purulent cervicitis
  • Pelvic TB

Absolute contraindications to IUD:

  • Copper allergy
  • Wilson’s disease

Absolute contraindications to IUS:

  • Current breast cancer

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