Malposition and displacement of intrauterine devices–diagnosis, management and prevention

Wildemeersch, Dirk; Hasskamp, Thomas; Goldstuck, Norman D

doi:10.15761/cogrm.1000145

Cited by 8 publications

(9 citation statements)

References 31 publications

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“…12 Reduction of the incidence of IUCD displacement can be done by proper insertion technique, proper selection of cases and modifications of the IUCD (small sized IUCDs and frameless IUDs). 13 Embedment as diagnosed on USG, refers to IUCD penetration into the endometrium or myometrium without extension through the serosa. It may occur up to some degree in up to 18% of females with an IUCD.…”

Section: Resultsmentioning

confidence: 99%

“…of cases with missing strings. 13,18 An expulsion rate 2-10 % in 1st year of use, has been quoted. 19 In our study spontaneous expulsion of IUCD in women with missed IUCD threads was found to be less (4.35%, n=3), as our study population included the interval insertions also.…”

Section: Resultsmentioning

confidence: 99%

“…It is recommended to remove all low-lying (>3 mm from the fundus) copper IUCDs as adequate protection cannot be guaranteed. 13 Also, all misplaced including embedded, extra-uterine IUCDs require removal.…”

Section: Resultsmentioning

confidence: 99%

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Missing IUCD strings: an analysis

Verma

Gupta²,

Saini

2018

Int J Reprod Contracept Obstet Gynecol

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Background: Missing IUCD strings, i.e. IUCD strings that are not visible at the external cervical os, are a commonly encountered problem and needs to be analysed.Methods: IUCD users coming for routine checkup (follow-up / renewal / removal) or with any complaints related to IUCD or gynecological complaints or referred from other health center and found to be having missing threads were included in the study. Complaints by woman, obstetric history, details of IUCD insertion, USG imaging reports were recorded. Removal of IUCD was done if indicated or if the woman desired so, by simple OPD procedure and if required in operation theatre.Results: Out of 324 IUCD users who were examined in OPD, missing IUCD threads were found in 69. About half of them were asymptomatic. AUB was the commonest symptom. 82.6% women had IUCD in situ on USG. Displacement was seen in 10.14%, embedment in 4.35%. Expulsion was seen in 4.35% women. Removal was done in only 29 women. Removal was done by simple OPD procedure in 24 women, as minor OT procedure in 3. Only 1 required hysteroscopic removal. Commonest cause of missing threads was found to be broken, detached or severed strings.Conclusions: As most of these women with missed IUCD strings, IUCD was found to be in situ on ultrasound imaging; hence, these women need counselling regarding continuation of using IUCD. If required, removal can be done as an OPD procedure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Missing IUCD strings: an analysis

Verma

Gupta²,

Saini

2018

Int J Reprod Contracept Obstet Gynecol

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“…Literature specifically pertaining to IUD displacement into a CS scar is limited. However, an IUD displacement is generally shown to have the potential to cause abnormal uterine bleeding and pain along with a rare perforation risk of 0.1-0.2%, a percentage that is higher with inexperienced clinicians, IUD placements prior to six months postpartum, nulliparity, and higher miscarriage rates [6,7]. Although provider experience may influence proper IUD placement, IUD displacement has been associated primarily with the discrepancy between the IUD and uterine width cavity [6].…”

Section: Discussionmentioning

confidence: 99%

“…Of note, compared to patients with misplaced coppercontaining IUDs, patients with misplaced LNG-IUDs have lower risks of adhesion formation and contraceptive failure [8]. In the asymptomatic patient, current recommendations point to expectant management; in the symptomatic patient, removal followed by replacement is favorable [6].…”

Section: Discussionmentioning

confidence: 99%

Intrauterine device displacement into a cesarean section scar

Park¹,

King²,

Schmitt³

2022

J Case Rep Images Obstet Gynecol

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Introduction:The rate of cesarean section (CS) delivery continues to trend upwards. The popularity of the intrauterine device (IUD) parallels this upward trend. Instances of IUD displacement into a CS scar have been rarely reported. The incidence, effects, and management of such a specific IUD displacement could be worth exploring in both asymptomatic and symptomatic patients.Case Report: We present a case of IUD displacement into a CS scar in a symptomatic patient. A 41-yearold woman with a surgical history of three cesarean sections presented for a removal and replacement of her levonorgestrel-releasing intrauterine device (LNG-IUD). After an uncomplicated removal and replacement, the patient's replacement IUD was found displaced at the level of the CS scar via a trans-vaginal ultrasound (TVUS). No further intervention with this replacement IUD occurred due to lack of symptoms.Two years later, the patient had menstrual irregularities and pelvic pain associated with the IUD displacement, warranting its removal and replacement. In the weeks following this second removal and replacement with a

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