Hariyana-CHO-2021
Obstetrics & Gynaecology
Medium
PPIUCD can be placed in the following conditions except ?
Appeared in: Hariyana-CHO-2021
Explanation
- The correct answer identifies the time frame that includes the period when PPIUCD insertion is generally avoided.
- Insertion is not recommended between 48 hours and 4-6 weeks postpartum.
- This specific window carries a higher risk of complications, including uterine perforation and device expulsion, because the uterus is undergoing rapid involution (shrinking).
- The option "Within 6 week of the child birth" is the only choice that encompasses this high-risk, contraindicated period.
Why Other Options Were Wrong
- Option A: This option describes post-placental insertion (within 10 minutes of delivering the placenta), which is an ideal and recommended time for PPIUCD placement.
- Option B: This option describes immediate postpartum insertion, which is also a recommended and safe window for placing a PPIUCD.
- Option D: This option describes interval insertion, which is a standard and safe time for IUD placement after the uterus has fully involuted.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Timing of Postpartum Intrauterine Contraceptive Device (PPIUCD) Insertion as background academic context rather than a clinical decision trigger.
- Nurses are central to counseling women on postpartum contraception. Understanding the precise timing for PPIUCD insertion is crucial for providing accurate information and ensuring patient safety.
- Educating patients about the increased risks of expulsion and perforation during the 48-hour to 6-week postpartum window is a key nursing responsibility to facilitate informed decision-making.
- What if? A patient who delivered 2 weeks ago requests an IUD. The nurse should explain that this is a high-risk period for insertion and advise waiting until her 6-week postpartum check-up for a much safer 'interval' insertion.
How to Approach the Question
- First, identify the keyword "except." This means you are looking for the option that represents a time when PPIUCD insertion is NOT recommended.
- Recall the different time windows for postpartum IUD insertion.
- Categorize the windows into 'recommended' and 'not recommended' based on safety and risk of complications.
- The recommended windows are: post-placental (immediately after placenta delivery), immediate postpartum (up to 48 hours), and interval (after 4-6 weeks).
- The 'not recommended' or 'avoid' window is the period between 48 hours and 4-6 weeks, due to high risks of expulsion and perforation.
- Evaluate each option against these windows. Option C, "Within 6 week of the child birth," is the only one that contains the entire 'not recommended' period.
Concept Tested & Keywords
- Concept Tested: Timing of Postpartum Intrauterine Contraceptive Device (PPIUCD) Insertion
- Stem keywords: PPIUCD, placed, conditions
- Lead-in keywords: except
- Negative lead-in flag: The question asks for the exception, meaning the time when PPIUCD insertion is contraindicated.
Question ID
QyLUv7IePFYIpPdeW8Q2dA
Reference Book
E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 191-193
E6 Obstetrics Williams p. 74-89
Practise the full Hariyana-CHO-2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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