Commonest complication of IUD insertion is?

HPSSSB Staff Nurse - 2016

Obstetrics and Midwifery Nursing

Easy

Appeared in: HPSSSB Staff Nurse - 2016

Explanation

Bleeding is the most frequent complaint following IUD insertion, affecting a large number of users, particularly in the initial 1-2 months.
This complication can manifest as intermenstrual spotting, longer menstrual periods, or a greater volume of blood loss (menorrhagia), especially with copper IUDs.
According to medical literature, abnormal bleeding is a leading cause for IUD removal, accounting for 10–20 percent of all discontinuations.

Option A: While pain and cramping are common, especially during and shortly after insertion, they are considered the second most common side effect, after bleeding.
Option B: Uterine perforation is a serious but rare complication. Its incidence is approximately 1-2 per 1,000 insertions, making it far less common than bleeding or pain.
Option D: IUDs are highly effective at preventing all pregnancies, which means they reduce the absolute risk of ectopic pregnancy compared to using no contraception. It is not a common complication of IUD use.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Intrauterine Device (IUD) insertion as background academic context rather than a clinical decision trigger.
Nurses must effectively counsel patients that irregular bleeding and spotting are very common in the first 3-6 months post-insertion and usually improve over time. This manages patient expectations and can improve IUD continuation rates.
Educating patients on the 'PAINS' acronym (Period late/abnormal bleeding, Abdominal pain, Infection signs, Not feeling well, String missing) is a critical patient safety intervention, empowering them to recognize and report potential serious complications promptly.
What if? If a patient using a copper IUD reports persistently heavy menstrual bleeding causing fatigue and pallor, the nurse should anticipate assessing for anemia (e.g., checking hemoglobin/hematocrit) and discussing alternative contraceptive methods if the bleeding is clinically significant or intolerable for the patient.

How to Approach the Question

This is a factual recall question that asks for the 'commonest' complication.
First, identify the keyword 'commonest,' which requires you to compare the frequency of the given options.
Recall or deduce the relative incidence of IUD side effects and complications.
Bleeding and pain are well-known common side effects. Perforation and ectopic pregnancy are known to be rare but serious risks.
Between bleeding and pain, bleeding is consistently cited in literature as the most frequent complaint and the primary reason for discontinuation.
Therefore, select the option that represents the most frequent occurrence.

Concept Tested & Keywords

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