Low-lying or malpositioned intrauterine devices and systems

Golightly, Ellen; Gebbie, Ailsa

doi:10.1136/jfprhc-2013-100684

Cited by 13 publications

(6 citation statements)

References 15 publications

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“…While many studies examining IUD failures, i.e. pregnancies with IUDs in utero, have noted malpositioned IUDs, it is unclear if IUD failure occurred due to the malpositioned IUD or if the IUD became displaced due to the enlarging gestational sac [66]. The importance of malpositioned IUDs has not been studied specifically for postplacental IUD insertions.…”

Section: Use Of Ultrasound For Follow-up and Surveillancementioning

confidence: 99%

Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices

Whitaker

Chen

2018

Contraception

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Postplacental intrauterine device (IUD) placement, defined as IUD placement within 10 min after delivery of the placenta, is an appealing strategy for increasing access to postpartum IUDs because it does not require a separate postpartum visit. These guidelines present an evidence-based assessment of postplacental IUD placement after vaginal and cesarean delivery. Postplacental IUD insertion is safe and does not have higher risks of complications than interval insertion. Most studies find that the risk of IUD expulsion is higher after postplacental insertion than after interval insertion for both vaginal and cesarean deliveries. Most studies find higher rates of expulsion after vaginal delivery than after cesarean delivery. However, expulsion rates vary widely across studies, without clear evidence about the factors that may influence expulsion. In settings where replacement of expelled IUDs is available, patient populations with low rates of return for the postpartum visit are most likely to benefit from provision of postplacental IUD placement with appropriate counseling about risks and benefits.

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Section: Use Of Ultrasound For Follow-up and Surveillancementioning

confidence: 99%

Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices

Whitaker

Chen

2018

Contraception

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“…According to potential severe complications of this phenomenon such as bladder or bowel perforation, it is important to confirm the proper place of the device in the uterine cavity as soon as possible [7–9]. Therefore, it is recommended to do regular exams to observe and palpate the strings of the IUD along the ultrasound immediately after insertion to affirm the correct insertion [12, 13]. The incidence of bladder perforation following IUD insertion is less than 5 per 1000 cases whose incidence can grow in cases of weakened uterine walls as in the current case [8, 9, 14, 15].…”

Section: Discussionmentioning

confidence: 99%

Cystoscopic removal of a migrated intrauterine device to the bladder; a case report

Vahdat

Gorginzadeh

Mousavi

et al. 2019

Contracept Reprod Med

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Background An intrauterine device (IUD) is a well-accepted means of reversible contraception. Migration of IUD to the bladder through partial or complete perforation has been rarely reported. This phenomenon could be strongly associated with history of prior cesarean sections (C-section) or early insertion of the device in the postpartum period. Case presentation In this study, a case of copper IUD migration through cesarean scar defect is presented, in such a way that was successfully managed by cystoscopic removal. A 31-year-old female with a history of lower urinary symptoms referred to the clinic for her secondary infertility work-up. A copper IUD outside the uterus in the bladder was found using hysterosalpingraphy. A plain abdominal radiography also confirmed the presence of a T-shaped IUD in the pelvis. According to ultrasound, the copper IUD was partly in the bladder lumen and within the bladder wall. The patient had a history of an intrauterine device insertion eight years ago followingher second cesarean delivery. Three years later, her IUD was expelled, and another copper IUD was inserted. Thesecond copper IUD was alsoremoved while she decided to be pregnant. The patient finally underwent a hysteroscopic cystoscopy. The intrauterine device with its short arms embedded in the bladder wall was successfully extracted through the urethra. Conclusions IUD insertion seems to be more challenging in women with prior uterine incisions and requires more attention. Cystoscopic removal should be considered as a safe and effective minimally invasive approach tomanage a migrated intrauterine device in the bladder.

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“…Laparotomy should remain the optimal option for most of the complicated cases [ 3 ]. In case of migration in areas such as the rectosigmoid, the colon, or the urinary bladder, other minimally invasive methods should be considered, such as colonoscopy and cystoscopy, as more appropriate [ 11 , 12 , 13 , 14 , 15 ]. The strong point of our case report is represented by the levonorgestrel-releasing IUD detected as migrated before perforating the serosa and bringing about serious consequences for the patient.…”

mentioning

confidence: 99%

An Interesting Image of Transmural Migration of a Levonorgestrel-Releasing Intrauterine Device (LNg-IUD)

et al. 2022

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Intrauterine devices (IUDs) are very common as a method of birth control. By adding progesterone (levonorgestrel), a decrease in the risk of complications has been documented, including the risk of perforation. Even though only a few complications have been described, adjacent organs may be involved in the case of migration—a life-threatening situation. A 45-year-old G4P2 woman was seen in our clinic for LNg-IUD removal, according to the medical instructions. Her main complaints were abdominal discomfort, low back pain, and recurrent menorrhagia. A “lost” IUD was initially suspected; the patient confirmed the detection and removal of the control strings, and a subsequent discussion related to delayed transmural migration of the IUD being followed. The ultrasonography revealed the migration of the IUD to the uterine cervix and size-decreased uterine fibroids, confirming the effectiveness of the LNg-IUD. The MRI and ultrasonography being useless, a subsequent X-ray and CT scan were requested, both confirming a myometrium-positioned IUD, adjacent to the serosa and lumbosacral plexus. Even though the IUD is considered a safe device with reversible effect, it can be associated with severe morbidity, with an ultrasound follow-up being required. For more precise detection of the IUD, we strongly recommend an X-ray or CT scan examination, followed by safe removal.

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Low-lying or malpositioned intrauterine devices and systems

Cited by 13 publications

References 15 publications

Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices

Society of Family Planning Guidelines: Postplacental insertion of intrauterine devices

Cystoscopic removal of a migrated intrauterine device to the bladder; a case report

An Interesting Image of Transmural Migration of a Levonorgestrel-Releasing Intrauterine Device (LNg-IUD)

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