A 32 yr old lady came with c/o 5wks amenorrhea .she gave the history of cu t insertion 2yr back. she is para 2 with full term normal delivery .last child born 3yrs back.3rd foetus had enencephaly so was terminated at 18 th WK of gestation.. plz share your valuable opinion about the case .

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early pregnancy with state uterus and partially expelled copper T septate uterus is the cause of copper T expulsion. if patient wants to continue pregnancy,remove copper T and monitor her pregnancy. give tab dydrogesterone 10 mg bd till delivery. there are chances of abortion,abnormal baby as she had an anomalous child earlier preterm labour,iugr and malpresentations are expected problems. if patient is not interested in continuing pregnancy,do MTP and tubectomy.

mam,here cu t inserted in septate uterus,may be bcoz it was not anticipated in view of history.do we need to do a routine usg before insertion to avoid situations like this.kindly answer.thank u.
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Y can remove Cut ,its quite lower down, just pull it. Continue preg if she is keen for No harm in continuing But support her with natural progesterone, regular folic acid Regular ANC Anomaly scan at 16 & 18 wks.

Partially expelled Cu-T with early pregnancy.P/S if Cu-T is visible out side d cx ,it can be removed. Contiue pregnancy if pt wants to continue it.Risk of abortion nd anomalies should be explained to her.During routine fetal scan Cu-T should be checked if it is not removed.Sometimes spontaneous expulsion of Cu-T will occur.lf Cu-T was visualised before delivery in d scan check for Cu-T in d placenta & membranes.

She has two healthy children,if she doesn't want third child u can go for termination by mtp kit.Cu t can be removed easily by pulling,if she wants to cont preg.

First of all is the pregnancy wanted/unwanted .if it is wanted pregnancy since the IUCD is low lying she can continue pregnancy but consequences has to be told clearly ..if it is unwanted remove CUT n then D&C is done

It can be done in single sitting, or even kit will do,iucd gets expelled out.
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Remove cuT n continue pregnancy if ur client want but explain her risk of abortion and give tt as usual otherwise I do mtp with consent in she wants to continue rule out congenital anomaly at 18 -20 wks gestation

Its a failure of contraception;u can do MTP with cu-T removal; but if pt is willing to continue preg explain her further consequences regardind abortion , remove cu-t and continue with routine anc care

Termination of pregnancy

remove cut. if she wants mtp do it. if she wants to continue.. continue. slight increase in chance of miscarriage and preterm delivery.

remove Cu t then plan for d&c....if willing t terminate......and tubectomy

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