ENUMERATION MIDTERMS

• FIMBRIAE

• INFUNDIBULUM

• AMPULLA

• ISTHMUS

4 PARTS OF THE FALLOPIAN TUBE

• BIPOLAR COAGULATION

• SPRING CLIPS/TUBAL CLIPS

• SILICONE BANDS/TUBAL RINGS

• REMOVAL (FIMBRIECTOMY/SALPINGECTOMY)

4 METHODS OF BLOCKING THE TUBES

• POSTPARTUM TUBAL LIGATION

• INTERVAL TUBAL LIGATION

WHEN TO UNDERGO BTL?

99.6% - 99.8%.

An overall effectiveness of BTL is placed at

• Women who are pregnant at the time of sterilization (luteal phase pregnancy)

• Surgical error

• Equipment failure (i.e. laparoscopic BTL)

• Spontaneous reanastomosis

(4) BTL Failure could be due to:

• WOUND INFECTION

• HEMATOMA

• UTERINE PERFORATION WITH THE ELEVATING INSTRUMENTS

• BLADDER INJURY

• ANESTHESIA COMPLICATIONS

• STERILIZATION FAILURE

6 BTL COMPLICATIONS

• Immediate post-operative fever (38°C

and above)

• Weakness

• Rapid pulse

• Persistent abdominal pain

• Vomiting

• Presence of pus or tenderness on the surgical site

6 WARNING SIGNS

• Unprotected sexual intercourse before the reproductive tract is cleared of sperm.

• Spontaneous recanalization of the vas deferens.

• Occlusion of the wrong structure during surgery

• In very rare cases, a congenital duplication of the vas that went unnoticed during the procedure

4 VASECTOMY Failure are usually due to: 

38°C or higher

WARNING SIGNS (VASECTOMY)

• Swelling, discoloration, discomfort and pain

• Hematomas

• Wound infection

• Granulomas can occur at the surgical site or in the epididymis

• Epididymitis

• Failure rate

6 COMPLICATIONS (VASECTOMY)

Benefits

Risks

Alternative

Inquiries

Decision to change

Explanation 

Documentation 

BRAIDED means

• Highly effective and inexpensive.

• Long-lasting (up to 8 years, per WHO).

• Can be removed anytime if pregnancy is desired .

• Safe during lactation.

• No effect on sexual activity.

5 IUD ADVANTAGES

• Mild discomfort during insertion/removal.

• Possible irregular bleeding, spotting, or cramps.

• Risk of expulsion, usually during menstruation.

• Vaginal discharge (initial reaction)

4 IUD DISADVANTAGES

• Spotting, bleeding, hemorrhage and anemia

• Cramping and pain

• Lost IUD strings

• Difficulty in removing an embedded IUD

• Ectopic pregnancy

• Uterine/cervical perforation

• IUD expulsion

7 IUD COMPLICATIONS

• Suspected pregnancy.

• Cervical or uterine cancer.

• Pelvic inflammatory disease.

• Severe abnormal bleeding.

4 CONTRAINDICATIONS

• Severe anemia.

• Vaginal infection.

• Distorted uterine cavity (e.g., fibroids).

• History of ectopic pregnancy.

• Risk of infections (e.g., uncontrolled diabetes, immunosuppression)

5 PRECAUTIONS

• PREPARATION FOR INSERTION

• INSERTION TECHNIQUES

• COMMON PROBLEMS DURING INSERTION

3 IUD INSERTION PROCESS

• (INSTRUMENTS AND SUPPLIES NEEDED)

• INSTRUMENT HANDLING AND CONTAMINATION PREVENTION

2 PREPARATION FOR INSERTION

• CLIENT PREPARATION

• INSERTION PROCEDURE

2 INSERTION TECHNIQUES

• OBSTRUCTION WHILE SOUNDING THE UTERUS

• ALIGNING THE UTERUS BY TRACTION

2 COMMON PROBLEMS DURING INSERTION

• Nausea

• Mild-to-moderate lower abdominal cramping

• Rarely, fainting (syncope)

• Clients are advised to stay 15–30 minutes at the clinic before discharge in case these occur

4 POSSIBLE SIDE EFFECTS RIGHT AFTER INSERTION

P- Period late (pregnancy), abnormal spotting on

bleeding

A - Abdominal pain, pain with intercourse

I - Infection exposure (such as Gonorrhea,

abnormal discharge

N- Not feeling well, fever, chills

S- String missing, shorter or longer

5 Signs and symptoms to watch out for:

• Several times in the first month, then after each period.

• Also check if there’s cramping, spotting, pain after sex, or if partner feels discomfort.

• Expulsion often happens during menstruation, so check pads or toilet.

• If expelled, return to clinic and use backup contraception

When to Check Strings (4)

• Anytime the woman wants.

• If side effects or health issues continue.

• When the IUD expires (e.g., after 8 years)

When to remove IUD? (3)

• Strings curled upward into the cervical canal or uterus

• String retraction due to uterine contractions

• IUD malposition or expulsion

• Incorrect string cutting (too short).

4 COMMON REASONS FOR MISSING STRINGS

• Implanon

• Jadelle

2 Types of Implants

• It is reversible, fertility returns almost immediately after the rods are removed

• Does not require daily intake

• Does not interfere with intercourse

• Effective within 24hours after insertion

• No estrogen-related side effects like nausea and dizziness

• Does not affect the quantity and quality of breast milk.

• Has beneficial non-contraceptive effects

• Helps prevent iron-deficiency anemia

• Makes sickle cell crises less frequent and less painful

• Helps reduce risk of endometrial cancer

• Reduces risk of ectopic pregnancies

11 Advantages of Subdermal Implant

• Clients cannot start or stop use on their own.

• Minor surgical procedure with local anesthesia is required to insert and to remove rods.

• Discomfort at the insertion site is common up to several days after insertion.

• Rods must be removed after a certain period

• Initial cost is high and it is usually harder to remove than to insert.

• No protection against STI like HIV/AIDS.

• In very rare cases, one in every six pregnancies is ectopic

7 Disadvantages of Subdermal Implant

• Light spotting or irregular bleeding between monthly periods

• Headaches

• Abdominal pain

• Acne(worsen or improve)

• Weight change

• Breast tenderness

• Dizziness

• Mood changes

8 Side Effects of IMPLANT

• None or none-hormonal contraceptives

• Switching from another hormonal method

• Implanon/Intrauterine System

• Postpartum (breastfeeding)

• Postpartum (not breastfeeding)

• Post-abortion clients

WHEN TO START USING SUBDERMAL IMPLANTS? (6)