Continuous sonographic monitoring of IUD extraction during pregnancy: preliminary report

Shalev, Josef; Greif, Martina; Ben‐Rafael, Zion; Itzchak, Y; Serr, D M

doi:10.2214/ajr.139.3.521

Cited by 9 publications

(4 citation statements)

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“…We found multiple case reports citing the benefits of using ultrasound guidance in removing an IUD in pregnancy [16,20]. However, there are only two case reports in which the addition of ultrasound guidance was valuable in removing an IUD when conventional methods had failed in non-pregnant patients [16,21,22].…”

Section: Discussionmentioning

confidence: 99%

Safe and cost-effective ultrasound guided removal of retained intrauterine device: our experience

2015

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Section: Discussionmentioning

confidence: 99%

Safe and cost-effective ultrasound guided removal of retained intrauterine device: our experience

2015

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“…10 In the second report, the woman had a paracervical block, use of a Novak curettage to dislodge the IUS and then passage of a long Kelly clamp to grasp it. 11 To the best of our knowledge, this is the first case series demonstrating an additional benefit with using ultrasound guidance for the removal of an IUS and the safety of this technique to be published. It is also the first time that ultrasound-guided retrieval of an IUS has been described without the use of any local or regional anaesthesia.…”

Section: Discussionmentioning

confidence: 83%

“…[6][7][8] However, there are little published data on the value of ultrasound guidance in the removal of an IUS. 11 There has been little published since. 9,10 There are also case reports citing the benefits of using ultrasound guidance of removing an IUS in pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness and safety of ultrasound-guided removal of a Mirena^®intrauterine system when the strings are not visible and conventional office procedures have failed

Mizia

Ramsay

2013

Aust N Z J Obstet Gynaecol

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Ultrasonic monitoring under local anesthesia during removal of an embedded intrauterine contraceptive device

Reuter¹,

Daly²

1986

J of Clinical Ultrasound

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Successful removal of an embedded intrauterine contraceptive device (IUD) under ultrasonic guidance and local anesthesia is reported in a case in which conventional methods of removal had failed. CASE REPORTA 32-year-old gravida 2 para 2 woman was referred to our institution for hysteroscopic removal of a Lippes' loop that had been in place for 9 years. Previous attempts to extract the IUD had failed. During the first attempt 3 weeks earlier, the IUD string had broken while being pulled during an office pelvic examination. An abdominal film taken 1 day later indicated that the Lippes' loop was probably in an appropriate location for intrauterine manipulation. During a subsequent dilatation and curettage under general anesthesia, the IUD was felt but still could not be removed. The patient was referred for hysteroscopic removal of the IUD.Physical examination at our institution disclosed that the abdomen was soft, without masses, and with normal bowel sounds. External and internal pelvic examinations were normal, revealing a multiparous cervix. On real-time ultrasound examination (Fig. l), the Lippes' loop was located primarily intracavitary but partially embedded in the posterior superior aspect of the uterine fundus, without penetration through the myometrium. After completion of the preliminary scan, 10 ml of 1% lidocaine was administered as a paracervical block in an arc from 2-10 o'clock around the cervix. Under continuous- 68sector real-time ultrasonic visualization, the portion of the IUD embedded in the uterine wall was dislodged with a Novak curette by hooking the Lippes' loop on the teeth of the curette at the point of penetration of the IUD into the uterine myometrium. This was guided by ultrasound, with the vaginal operator viewing the video screen and requesting appropriate changes in orientation of the ultrasound transducer in consultation with the ultrasonographer to obtain maximum visualization. (Unfortunately, the portable equipment used in this procedure was not connected to a video recorder, so that no recording of the actual removal is available.) Once the loop was freed from the embedded region, it was grasped with a long Kelly clamp at the level of the lower uterine segment and removed. Approximately 10 ml of blood was lost during the procedure. After a brief period of observation, the patient was discharged on a 48-h course of tetracycline and had an unremarkable recovery. DISCUSSIONSonography without general anesthesia has been used to monitor continuously the extraction of IUDs during pregnancy to prevent injury to the gestational sac.' Sonographic monitoring has also been performed with general anesthesia for removal of an embedded Fincoid IUD.2 In the latter case, a broken IUD string had prevented simple removal by pulling. The use of arborization forceps after paracervical local anesthesia and cervical dilatation also was not successful; nor was an attempt with the addition of general anesthesia, a hook specially designed for IUD removal, and Crossen-Gilliam forceps. However, real-time...

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Continuous sonographic monitoring of IUD extraction during pregnancy: preliminary report

Cited by 9 publications

References 0 publications

Safe and cost-effective ultrasound guided removal of retained intrauterine device: our experience

Safe and cost-effective ultrasound guided removal of retained intrauterine device: our experience

The effectiveness and safety of ultrasound-guided removal of a Mirena^®intrauterine system when the strings are not visible and conventional office procedures have failed

Ultrasonic monitoring under local anesthesia during removal of an embedded intrauterine contraceptive device

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Continuous sonographic monitoring of IUD extraction during pregnancy: preliminary report

Cited by 9 publications

References 0 publications

Safe and cost-effective ultrasound guided removal of retained intrauterine device: our experience

Safe and cost-effective ultrasound guided removal of retained intrauterine device: our experience

The effectiveness and safety of ultrasound-guided removal of a Mirena®intrauterine system when the strings are not visible and conventional office procedures have failed

Ultrasonic monitoring under local anesthesia during removal of an embedded intrauterine contraceptive device

Contact Info

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Resources

About

The effectiveness and safety of ultrasound-guided removal of a Mirena^®intrauterine system when the strings are not visible and conventional office procedures have failed