Where is the mirena placed
Animation for insertion of Mirena IUD
Maryna insertion and removal replacement
preparation for insertion examine the
patient to establish the size and
position of the uterus and in order to
detect any signs of acute genital
infections or other contraindications
for the insertion of Mirena and to
exclude pregnancy insert a speculum
visualize the cervix and then cleanse
the cervix and vagina with a suitable
antiseptic solution grasp the anterior
lip of the cervix with the tenaculum to
stabilize a uterus
if the uterus is ret reverted it may be
more appropriate to grasp the posterior
lip of the cervix gentle traction on the
forceps can be applied to straighten the
cervical canal the forceps should remain
in position and gentle counter traction
on the cervix should be maintained
throughout the insertion procedure
advance uterine sound through the
cervical canal to the fundus to measure
the depth and confirm the direction of
the uterine cavity if difficulties
encountered consider dilatation of the
canal insertion first open sterile
package completely then use sterile
technique and sterile gloves
Mirena is provided within an inserter
consisting of the Mirena itself already
in the correct horizontal position an
anatomically curved insertion tube with
a double-sided centimeter scale and a
plunger inside the flange and the handle
containing the mark the slider and the
threads inside
push the slider forward in the direction
of the arrow to the furthest position to
load Mirena into the insertion tube do
not pull the slider downwards as this
may prematurely release Mirena once
release Mirena cannot be reloaded
holding the slide in the furthest
position set the upper edge of the
flange to correspond to the sound
measurement of the uterine depth while
holding the slide in the furthest
position advance insert earth through
the cervix until the flange is
approximately 1.5 to 2 centimeters from
the uterine cervix do not force the
inserter dilate the cervical canal if
necessary while holding the insert a
steady pull the slider to the mark to
open the horizontal arms of Mirena wait
5 to 10 seconds for the horizontal arms
to open completely advance inserted
gently towards the fundus of the uterus
until the flange touches the cervix
Mirena is now in the fundal position
holding the inserter in place release
Mirena by pulling the slider all the way
down while holding the slider all the
way down gently removed the inserter by
pulling it out
cut the threads to leave about 2 to 3
centimeters visible outside of the
cervix Mirena insertion is now completed
removal replacement Mirena is removed by
pulling on the threads with the forceps
you may insert a new Mirena immediately
following removal for full information
consult the insertion instructions in
the Mirena package
