When would you hold anticoagulation medications in patients undergoing a tandem and ovoid/ring?  

We usually don’t hold unless planned for hybrid with needle placement. We would make sure sonogram is available for placement of tandem to avoid false track.

We do not hold anticoagulants for intracavitary brachytherapy alone. I think, if you use a Smit sleeve without ultrasound or omit the Smit Sleeve, but have ultrasound to confirm placement it is fine.  I would not routinely recommend insertion of tandem without either a smit sleeve or without ...