Which of the following is a third-generation intrauterine device (IUD)?

JIPMER Nursing Officer-2024

Obstetrics and Midwifery Nursing

Easy

Appeared in: JIPMER Nursing Officer-2024

Explanation

Progestasert is correctly identified as a third-generation intrauterine device (IUD).
Third-generation IUDs are defined by their ability to release a hormone, typically a progestin.
Progestasert contains and slowly releases progesterone into the uterine cavity.
This hormonal action thickens cervical mucus, preventing sperm entry, and alters the endometrium, making it unsuitable for implantation.

Option A: Copper-T 380A is a second-generation IUD, not a third-generation one.
Option B: Lippes loop is a first-generation IUD.
Option D: Multiload-375 is a second-generation IUD.

Visual 1: Infographic - A chart showing the three generations of IUDs with images, names, and key features (Inert, Copper, Hormone) for each generation. This helps in visual association and memory recall.
Visual 2: Diagram - An illustration comparing the mechanism of action of a copper IUD (spermicidal effect) versus a hormonal IUD (thickened cervical mucus and altered endometrium).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of Intrauterine Devices (IUDs) as background academic context rather than a clinical decision trigger.
Nurses must be able to differentiate between IUD types to provide accurate patient education regarding effectiveness, side effects, and duration of use. For example, copper IUDs can increase menstrual bleeding, while hormonal IUDs often reduce it.
Understanding the contraindications for each type is crucial for patient safety. A patient with Wilson's disease should not receive a copper IUD, and a patient with progestin-sensitive cancer should not receive a hormonal IUD.
What if? If a patient with very heavy and painful periods (menorrhagia and dysmenorrhea) requests an IUD, the nurse should anticipate that a second-generation copper IUD would likely worsen her symptoms. A third-generation levonorgestrel-releasing IUD (like Mirena) would be a more appropriate recommendation, as it is often used to treat these very conditions.

How to Approach the Question

First, identify the key terms in the question: 'third-generation' and 'intrauterine device (IUD)'.
This is a factual recall question that requires knowledge of contraceptive methods.
Recall the classification system for IUDs, which is based on their composition and mechanism.
Mentally categorize the generations: 1st Generation = Inert/Non-medicated (e.g., Lippes Loop); 2nd Generation = Copper-releasing (e.g., Copper-T); 3rd Generation = Hormone-releasing.
Evaluate each option against this classification: Copper-T 380A (2nd), Lippes loop (1st), Progestasert (hormone-releasing), Multiload-375 (2nd).
Identify Progestasert as the only hormone-releasing device in the list, thus making it the third-generation IUD.

Concept Tested & Keywords

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