Effect of time of removal of intrauterine contraceptive devices on implantation and blastocyst survival in the rat.
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Ultrasonic localization of missing IUDs was performed on 51 patients with a high degree of accuracy. This method also demonstrated pregnancy where present and other pathologic conditions including fibroids and ovarian cysts. Other methods recommended for localization of missing IUDs are discussed with particular reference to their adverse effects. A protocol for localizing missing IUDs using ultrasound is recommended.
The risk to the embryo and to the mother when pregnancy results with an intrauterine device (IUD) in the uterus is well documented. Current advice in such cases is to remove the IUD if the string is visible; proper management when the string is not accessible is controversial. In four such cases, we were able to remove the IUDs from inside the uterine cavity using a small alligator forceps guided by high-resolution ultrasound. All four pregnancies progressed successfully to term. Based on the literature and our own experience, we recommend removal of IUDs or therapeutic abortion when pregnancy occurs with an IUD in situ.
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