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RELAX (IUD TCu 380A)

এসএমসি নিয়ে এল রিল্যাক্স দীর্ঘমেয়াদি জন্মরোধ করার আধুনিক পদ্ধতি। এটি হরমোন-বিহীন একটি পদ্ধতি, তাই অনেক মহিলার জন্য এটি উপযোগী। প্রশিক্ষণ-প্রাপ্ত ডাক্তারদের মাধ্যমে রিল্যাক্স আইইউডি মহিলাদের জরায়ুর ভিতরে স্থাপন করতে হয়। এটি ছোট “T” আকৃতির কপার সমৃদ্ধ আইইউডি যা ব্রাজিলিয়ান কোম্পানি ইঞ্জেফ্লেক্স এর তৈরি। রিল্যাক্স বিভিন্নভাবে পরীক্ষিত এবং বাংলাদেশসহ বিভিন্ন দেশে এ ধরনের আইইউডি-এর ব্যাপক প্রচলন রয়েছে। মাসিক শুরু হওয়ার ৭ দিনের মধ্যে এই পদ্ধতি গ্রহণ করা যায়। গ্রহণ করার সঙ্গে সঙ্গেই এই পদ্ধতি কার্যকর এবং খুলে ফেলার সাথে সাথেই পুনরায় গর্ভবতী হওয়া যায়। সিজারিয়ান অপারেশন ও প্রসব পরবর্তী সময়েও রিল্যাক্স আইইউডি পদ্ধতি গ্রহণ করা যায়।

সোশ্যাল মার্কেটিং কোম্পানী Long Acting Reversible Contraceptive (LARC) নেটওয়ার্ক-এর আওতায় প্রশিক্ষিত প্রাইভেট ডাক্তারদের মাধ্যমে ৫২৪৮ টি রিল্যাক্স আইইউডি প্রয়োগ করেছে।

  • RELAX (IUD TCu 380A)
  • Timing of the Insertion
  • Where to Get
  • RELAX (IUD TCu 380A)

    • SMC introduces Relax - a small, "T-shaped", copper-based device of the type IUD TCu 380A which is inserted into the uterus to prevent pregnancy
    • It is safe, effective, long-term and completely reversible upon removal
    • IUD TCu 380A non hormonal devices are widely tested and clinically approved in many countries around the world including Bangladesh

    Features

    • Relax is available in a pre-packed box with a loader for easy insertion along with a thin polyethylene string for easy removal
    • The edges of copper cylinders are rounded, reducing friction during insertion
    • There are no sharp edges for greater comfort
    • It is visible to X-rays and ultrasonography

    Advantages

    • Offers long-term contraception up to 10 years after insertion
    • Effective immediately after insertion
    • Fertility returns right after removal
    • Non-hormonal so no chance of hormonal side effects
    • Safe for lactating mothers
    • Can be inserted post partum (within 48 hours after expulsion of placenta)
    • Can be used more than once and inserted following removal of the previous one (if desired)

    Eligibility Criteria

    Almost all women of reproductive age with one living child can use Relax IUD safely and effectively. However, it is most recommended for women who-

    • Have at least one living child and contraindicated for hormonal contraceptive methods
    • Do not want any more children but are not interested in using a permanent method of contraception such as ligation
    • Are not sure whether they would like to have any more children in future
    • Have not had a history of pelvic infection or sexually transmitted diseases in the last three months

    Common Undesirable Effects:

    • During insertion: Mild cramping pain
    • First few days after insertion: Menstrual bleeding, mild cramping pain in the lower abdomen
    • First few months after insertion: Increased duration and/or amount of menstrual bleeding or spotting, cramps, intermenstrual bleeding, etc.

    Most side effects usually subside spontaneously within three or four months after insertion or with symptomatic treatment. There is no need to take any special intervention.

    Contraindications

    Women with the following diagnosis should not be inserted with IUD:

    • Pregnancy abnormalities of uterus, resulting in distortion of the uterine cavity
    • Acute PID or current behavior suggesting there is a high risk of pelvic inflammatory disease
    • Postpartum infection
    • Known or suspected uterine or cervical malignancy
    • Genital bleeding of unknown etiology
    • Mucopurulent cervicitis
    • Wilson’s disease
    • Allergy to any component of the IUD
    • Complicated valvular heart disease (e.g., artificial shunts, rheumatic heart disease)
    • Septic abortion
    • Heavy/prolonged menstruation
    • Women with irregular menstrual cycle
    • Severe dysmenorrhea
    • Severe anemia
    • Second and third degree uterine prolapse
    • Nulliparous women
  • During a Menstrual Cycle

    • Within first seven days of menstruation
    • Any time during the menstrual cycle if pregnancy is excluded

    Postpartum Period

    • Within 48 hours of normal vaginal delivery
    • Four weeks after delivery of a child
    • During caesarean operation

    During lactation period IUD can be given four weeks after delivery, if she exclusively breast feeds her baby and her menstruation has not returned.

    After Abortion

    • IUD can be inserted immediately or within seven days, if abortion occurs within 3 to 6 gestational months and there is no infection
    • If not inserted within seven days, IUD can be given any time, provided the service provider is reasonably sure that woman is not pregnant
    • If there is infection, appropriate treatment should be given or referred. Provide information on other FP options. IUD can be given after infection subsides
    • IUD can be inserted after abortion if abortion occurs after six gestational months. However, in such cases, special training is required

    Complications

    In rare cases, there may be some complications that may require treatment. These include:

    • Abnormal bleeding
    • Amenorrhea
    • Abnormal pain in the lower abdomen
    • Expulsion of the IUD
    • Pregnancy
    • Perforation
    • Missing thread

    It is necessary to explain to the client that she should report to her provider if any of the above symptoms occurs. In such cases, appropriate investigation and medication must be given to address the main problem. In some cases the IUD may have to be taken out.

    Follow-Up Visits

    The recommended routine follow up schedule is as follows:

    • First visit: After the first menstrual period (3-6 weeks)
    • Second visit: After 6 months of insertion
    • Third visit: After 12 months of insertion
    • Unscheduled visit: Any time after insertion of IUD as required

    References:

    1. Family Planning Manual, July 2012, Directorate General of Family Planning, GoB
    2. Optima IUD TCu 380A product brochure