Role of ultrasonography in managing IUD-related complaints

The study included 211 women using Cu-T 380A, of whom 155 presented with complaints related to IUD use. All women were examined by real-time ultrasound using abdominal sector and/or vaginal scanners. The parameters that were studied included the top-fundal distance (distance between the device top and the highest point in the uterine cavity), the intercornual and the fundus-isthmus diameters (of the uterine cavity). Any abnormal finding was also recorded. About 50% of complainers had top-fundal distance more than 4 mm, compared to 28% of non-complainers. An intercornual diameter, too small (less than 30 mm) or too wide (greater than or equal to 38 mm), was significantly more frequent in women complaining of bleeding and pain. Other abnormal findings were diagnosed in 25% of complainers compared to 7% in those without complaint. These findings included partial expulsion, appearance suggestive of pelvic inflammatory disease, ovarian swellings, embedding and fibroid uterus. Ultrasonography can give useful insights in managing IUD-related complaints in selected cases.