Liletta

History or risk of ectopic pregnancy. Assure suitable uterine anatomy before inserting. Risk of spontaneous abortion, miscarriage, sepsis, premature labor or delivery, congenital anomalies: remove if pregnant. Consider risks of PID before using. Bleeding pattern alterations: exclude endometrial pathology prior to insertion in women with persistent bleeding. Risk of perforation, expulsion and ovarian cysts. Increased risk of perforation in lactating women, if inserted in women with fixed retroverted uteri, or during postpartum period; and increased risk of explusion if inserted in women with uteri that is not completely involuted; delay insertion a minimum ≥4wks, or until involution is complete after delivery or a second trimester abortion. Breast cancer. Evaluate and consider patients' clinical conditions prior to use risk (eg, leukemia, AIDS, IV drug abuser). Anticoagulant therapy or coagulopathies. Cervical stenosis. Predisposition to syncope, bradycardia, other vasovagal reactions. Remove device if any of these occur: uterine or cervical perforation, embedment, pregnancy, symptomatic actinomycosis, pelvic infection, endometritis, any sign of expulsion. Consider removal if coagulopathy, migraine, transient cerebral ischemia, severe or frequent headache, marked increase in BP, severe arterial disease, uterine/cervical malignancy, or jaundice occurs. Nursing mothers.