Mirena/Skyla® IUD insertion A. Gently sound uterus

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Mirena/Skyla® IUD insertion A. Gently sound uterus Mirena/Skyla® IUD insertion A. Gently sound uterus. Push slider forward as far as possible to load IUD into insertion tube. DO NOT move slider downward at first as this may release the strings prematurely. The IUD cannot be reloaded after the slider is moved below the mark. Set flange to depth measured by sound. After grasping cervix with tenaculum or ring forcep, apply gentle traction and gently insert IUD into uterus. B. Continue to hold slider in forward position and advance insertion tube until flange is 1.5-2 cm from external os. Hold inserter steady and pull slider back to first mark to release arms of the IUD. Wait 10 seconds to allow arms to completely deploy. C. Gently push inserter into uterus until flange touches cervix (IUD should be at fundus). D. While holding inserter firmly, release IUD by pulling slider down all the way. Threads release automatically. Continue to hold slider all the way down as inserter is removed. Cut threads to leave 3-4 cm visible. (Used with permission from Cunningham F, et al. Contraception. In: Cunningham F, et al., eds. Williams Obstetrics, 24th ed. New York, NY: McGraw-Hill; 2013). Source: Gynecology, The Johns Hopkins Handbook of Obstetrics and Gynecology Citation: Szymanski LM, Bienstock JL. The Johns Hopkins Handbook of Obstetrics and Gynecology; 2015 Available at: https://obgyn.mhmedical.com/DownloadImage.aspx?image=/data/Books/1657/Szymanski_ch02_Fig-02-14.png&sec=107290550&BookID=1657&ChapterSecID=107290350&imagename= Accessed: November 12, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved