Follow-up after insertion of an IUCD

Routine follow-up

• at 3-6 weeks to check threads and exclude perforation
• return if problems or time for removal; no further follow-up needed

At first follow-up visit exclude infection, perforation or expulsion

Intrauterine device (IUD) only: For heavier and/or prolonged bleeding associated with use of an IUD:

• treat with non-steroidal anti-inflammatory drugs and tranexamic acid
• or suggest changing to the IUS if the woman finds bleeding unacceptable

If Actinomyces-like organisms are seen on a cervical smear, assess for pelvic infection, and remove the IUD or intrauterine system (IUS) (Mirena coil) if there are signs of infection

If a woman becomes pregnant with an intrauterine pregnancy, advise removal of the IUD or IUS before 12 weeks' gestation, whether or not she intends to continue the pregnancy

Reference:

1. NICE (2014). Long-acting reversible contraception