Postplacental Insert after expulsion of the placenta following a vag delivery on the same delivery table. W/in 48 hr after delivery Insert w/in 48 hr of vag delivery & prior to discharge from the postpartum ward.
Ruptured membranes >18 hr prior to delivery; diagnosis of chorio-amnionitis at the time of delivery; unresolved postpartum haemorrhage; >48 hr postpartum; undergone caesarean section.
Does not protect against HIV or other STIs. Should not be used in women w/ very high personal risk for certain STIs or w/ active RTI/STI. Perform a speculum or bimanual exam to check for partial or complete expulsion if severe uterine cramping occurs & persists after insertion. Full clinical evaluation needs to be done if the woman complains of fever; should use antibiotic regimen in the presence of endometritis. Spontaneous expulsion (most likely during the 1st 3 mth postpartum). Heavy vag bleeding, severe lower abdominal discomfort, unusual vag discharge.
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