IUD Contraception Device

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Questions and Answers

What is the primary mechanism of dinoprostone release from the vaginal insert?

Diffusion through the polyethylene oxide matrix

Chemical reaction with the cervical mucus

Dissolution of the swelling matrix design (correct)

Osmosis through the knitted polyester pouch

What is the recommended storage temperature for the vaginal insert?

4°C

-80°C

Room temperature

-20°C (correct)

What is the purpose of the knitted polyester pouch in the vaginal insert?

To stimulate uterine contractions

To release dinoprostone

To enclose the slab and retrieve the insert (correct)

To absorb cervical mucus

What is the rate of dinoprostone release from the vaginal insert?

0.3 mg/hr Signup and view all the answers

What is the indication for using the vaginal insert in the second trimester?

Second trimester abortion Signup and view all the answers

What is the importance of the patient being supine for 2 hours after administration of the vaginal insert?

To monitor for adverse reactions Signup and view all the answers

What is the purpose of cervical ripening in labor induction?

To reduce the need for oxytocin Signup and view all the answers

What is a characteristic of the polyethylene oxide matrix in the vaginal insert?

It is hygroscopic Signup and view all the answers

What is the purpose of adding titanium dioxide to EVA in hormone releasing IUDs?

To provide a white color Signup and view all the answers

What is the benefit of using a T-shaped delivery system in hormone releasing IUDs?

It reduces the risk of expulsion Signup and view all the answers

What is the advantage of using progesterone in hormone releasing IUDs?

It has fewer side effects compared to estrogen Signup and view all the answers

What is the mechanism of action of Cervidil?

It stimulates prostaglandin production Signup and view all the answers

Which method of contraception has a failure rate range of 1.9-2.0% over 12 months?

Progesterone-releasing IUD Signup and view all the answers

What is the purpose of using a cervical cap with spermicide as a method of contraception?

To prevent sperm from reaching the egg Signup and view all the answers

What is the benefit of using a vaginal insert for cervical ripening?

It has fewer side effects compared to oral medications Signup and view all the answers

What is the primary mechanism of action of progesterone in hormone releasing IUDs?

It prevents implantation Signup and view all the answers

What is the advantage of using a hormone releasing IUD compared to oral contraceptives?

It has fewer systemic side effects Signup and view all the answers

What is the primary purpose of using a progesterone releasing IUD?

To prevent implantation of a fertilized egg Signup and view all the answers

What is the primary mechanism of action of intrauterine progesterone DDS in preventing fertilization?

Reducing sperm motility and survival by increasing cervical mucus thickness Signup and view all the answers

What is the purpose of the small string that hangs down from the IUD into the upper part of the vagina?

To periodically check the device's location and detect any possible embedment Signup and view all the answers

What is the role of barium sulfate in the intrauterine progesterone DDS?

To make the device radiopaque Signup and view all the answers

What is the formulation of the progesterone in the intrauterine progesterone DDS?

Progesterone suspended in silicone oil Signup and view all the answers

What is the effect of progesterone on the cervical mucus in the context of contraception?

It increases the mucus thickness and reduces sperm motility and survival Signup and view all the answers

What is the role of the ethyl vinyl acetate (EVA) membrane in the intrauterine progesterone DDS?

To control the release of progesterone Signup and view all the answers

Study Notes

Vaginal Insert

A pouch of knitted polyester enclosing a slab, attached to a long knitted strap for retrieval.
Used for labor induction by initiation and/or continuation of cervical ripening, and for second-trimester abortion.
The drug is dispersed in a polyethylene oxide matrix and released at a rate of about 0.3 mg/hr.
Mechanism: In a moist environment, the unit absorbs water, swells, and releases dinoprostone in a controlled manner through diffusion.

Instructions and Storage

1 unit is inserted and removed upon induction of active labor.
Patient must be supine for 2 hours after administration.
Stored at -20°C to maintain stability.
Hygroscopic, and properties of the drug may be altered if stored improperly.

Vaginal Gel

Must be biodegradable and insoluble in the body.
Titanium dioxide is added to EVA for a white color.

IUD Insertion and Removal

The device is pushed out through the cervix.
Distance is adjusted to ensure proper positioning.

Intrauterine Progesterone DDS

Advantages: uses a natural hormone, contains no estrogen, and has a T-shaped delivery system that ensures comfort and safety.
Locally confines hormonal action to the uterus.
Confines irritation to the site of action.
Failure rates: 1.9-2.0% over 12 months for progesterone-releasing IUDs.

Cervidil

Composed of a semitransparent polymeric hydrogel containing dinoprostone.
Systemic progesterone absorption is low.
Mechanism of action: increases cervical mucus thickness and changes the lining of the uterus.

IUD Insertion & Removal (Cont'd)

A small string hangs down from the IUD into the upper part of the vagina for periodic checks.
A shorter-than-normal string can be a warning sign of an embedded IUD.

Intrauterine Progesterone DDS (Cont'd)

Contents: progesterone suspended in silicone oil, barium sulfate to make radiopaque, and an EVA membrane controlling drug release.

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Description

This quiz is about the structure and function of an intrauterine device (IUD) used for contraception.