Which group of women should NOT receive an intrauterine device?

• A. Women with a history of toxic shock syndrome
• B. Women who are at least 2 weeks postpartum
• C. Women with recurrent bladder infections
• D. Women experiencing heavy menstrual bleeding

Answer: (A)

Women with a history of toxic shock syndrome should not receive an intrauterine device (IUD). This is due to the risk that the presence of an IUD can increase the likelihood of developing an infection, which could potentially trigger another episode of toxic shock syndrome. The condition is associated with certain types of bacterial infections, particularly following the use of certain types of tampons or contraceptive devices. Therefore, for a woman with a documented history of toxic shock syndrome, the risks associated with an IUD may outweigh the benefits of using one.

Other groups mentioned, such as women who are at least 2 weeks postpartum, those with recurrent bladder infections, or those experiencing heavy menstrual bleeding, may have different considerations regarding IUD use, but they are not categorically contraindicated in the same way. The postpartum status may involve some special recommendations, but typically, if a woman is stable and her risk factors are managed, the IUD can be safely used. In the case of recurrent bladder infections or heavy menstrual bleeding, healthcare providers would evaluate those conditions individually, as an IUD can sometimes be beneficial for managing heavy menstrual bleeding specifically.