Postplacental Intrauterine Contraceptive Device Transmigration – Rare but the Real Concern for Service Providers

Abstract

Uterine perforation following postplacental intrauterine contraceptive device (PPIUCD) insertion is a rare event with a potential for serious injuries. In the present case, a young lady with a history of PPIUCD insertion presented with a mass having ill-defined margins and restricted mobility palpable in her right iliac region. Examination reported a conglomerated mass in right adnexa with an IUCD surrounded by a heterogeneous inflammatory collection to which omentum and bowel loops adherent to it. Additional imaging reported involvement of right iliac vessels and right ureter with upstream hydroureteronephrosis. Intraoperatively, ureter was found intact and away from the IUCD which was removed with a gentle pull, and a rent in the right posterolateral surface of uterus was repaired with delayed absorbable sutures. With PPIUCD services being provided on an unprecedented scale, it becomes prudent and ethically crucial to create a national repository to document post insertion outcomes and complications. Case report aims to inform and sensitize stakeholders about possible post insertion complications to help improve expansion of the PPIUCD programs.

Asymptomatic uterine perforation and IUD migration to the broad ligament: A case report

“…[ 9 , 10 ] Importantly, lactation and abortion, which were both present in our patient, have been identified as risk factors for uterine perforation with IUD insertion. As per the case report by Patel et al [ 11 ] on a 21-year-old patient with immediate IUD placement following spontaneous labor, uterine perforation occurred 18 months later, with findings of an inflammatory mass involving the right iliac vessel, ileus, and right ureter. The IUD was removed by laparotomy.…”