Which of the following is an important complication for copper intrauterine device?

RIMS Nursing Officer - 2022

Obstetrics & Gynaecology (E5)

Easy

Appeared in: RIMS Nursing Officer - 2022

Explanation

Pelvic infection, or Pelvic Inflammatory Disease (PID), is a well-documented and serious complication of IUD use.
The risk is highest in the first few weeks after insertion, as the procedure can introduce bacteria from the lower genital tract into the uterus.
Studies show that IUD users have a higher risk of developing PID compared to non-users, particularly if they have multiple sexual partners, increasing their exposure to STIs.
The clinical signs of PID include lower abdominal pain, fever, chills, and abnormal vaginal discharge.

Option A: There is no evidence suggesting that copper IUDs increase the risk of cervical cancer. Routine cervical cancer screening (Pap tests) should continue as recommended, but the IUD itself is not a causative factor.
Option B: Hypertension (high blood pressure) is not a complication of copper IUDs. These devices are non-hormonal and work locally, so they do not have systemic cardiovascular effects.
Option D: Benign breast disorders are not associated with copper IUDs. These conditions are often related to hormonal fluctuations, and since copper IUDs are non-hormonal, they do not affect breast tissue.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Copper Intrauterine Device (IUD) as background academic context rather than a clinical decision trigger.
A key nursing responsibility is to screen patients for contraindications before IUD insertion, including a history of PID, current STIs, or uterine abnormalities.
Strict aseptic technique during insertion is critical to minimize the risk of introducing bacteria into the uterus and causing a pelvic infection.
Patient education is paramount. The nurse must teach the patient the 'PAINS' warning signs and instruct them to seek immediate medical attention if any of them occur.

How to Approach the Question

First, identify the core subject of the question: complications of a 'copper intrauterine device'.
Recognize that a copper IUD is a non-hormonal contraceptive method. This helps eliminate options related to systemic hormonal side effects.
Evaluate the options based on the mechanism of the device. 'Hypertension' and 'Benign breast disorders' are systemic and often hormone-related, making them unlikely complications of a local, non-hormonal device.
Consider the physical presence and insertion process of the IUD. The device is placed through the cervix into the uterus, creating a potential pathway for infection. This makes 'Pelvic infection' a plausible complication.
Recall or deduce that IUDs are not linked to cancer. This eliminates 'Cervical cancer'.
Conclude that pelvic infection is the most direct and significant complication among the choices provided, stemming from the insertion process and the presence of a foreign body in the uterus.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 1 — Subpart C (pp 404-604 of 604) p. 192-194

E6 Gynecology Williams p. 116-144