QQ-3556. Ms Olivia Hawthorne - Nursing – Anitta Renjith – Intra-Uterine Device Removal

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Dr. Mirain Shah

Consultabt Obstetician

Royal Hospital

Lowtown

Dear Doctor,

Re: Ms Olivia Hawthome, aged 40

I am writing to refer Mrs Olivia Hawthome a 40 year old G3P2 woman for Further evaluation and management following unsuccessful removal of her Intrauterine device.

Mrs Hawthome was presented to the clinic with a 3 months history of menstrual spotting. She also experienced menorrhagea and dymenorrhea along with increased hairness and guariness to her skin. Therefore she was recommended canestan 5 and her IUD removal. Today, she was presented to us for the removal of Mirena coil but the attempt was a failure as she was unable to locate the string. Moreover she forget the date when she had felt the strings for the last time. A pregnancy test was also conducted which was negative.

Mrs Hawthome was diagnosed with menorrheagea and dymenorrhea since 10 years. She was also suffering from mental bleeding for 10 days. Hence, cerazilt and a combined pill, ecluf were prescribed but both were ineffective. In 2015 menorrhagei returned along with menstrual cycle, after the birth of her second child. Consequently, Mirune coil, but had a vaginal thrush which was treated with Canustan 5 last years.

In view of the above, ir would be greatly, appreciated if could counsuct further investigation and ultrasounds for her IUD removal. Please note that her string is suspected to be shifted or fallen out. Pertinant documents are enclosed for your reference.

If you have anu further queries, please feel free to contact me.

Your’s sincerely,

Registered Nurse.

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