Low-lying or malpositioned intrauterine devices and systems
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Updated: May 4, 2026

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Published on: February 5, 2021
Ellen Golightly1, Ailsa E Gebbie
1Specialist Registrar, Department of Obstetrics and Gynaecology, Royal Infirmary of Edinburgh, Edinburgh, UK.
Introduction:
The intrauterine device (IUD) and intrauterine system (IUS) are widely used forms of long-acting reversible contraception. Occasionally, IUD/IUS users have an ultrasound scan that shows a low-lying IUD/IUS or an IUD/IUS is found incidentally on scan to be low-lying within the uterus. No formal guidelines exist on the clinical implications of this scenario or the most appropriate management. We report here on a systematic review of the literature.
Methods:
A search of the online database PubMed was performed to identify articles relating to low-lying or malpositioned IUD/IUS.
Results:
A total of 1101 articles was identified, and 15 were determined to be relevant to the research question.
Discussion:
There is little published evidence to determine the nature and extent of the clinical relevance of a low-lying IUD. We recommend individualised management of these women, with particular caution in younger women and those with a history of previous IUD/IUS expulsion. Consideration may be given to attempting to readjust the IUD/IUS position, but if removal is performed, immediate replacement is essential if provision of alternative effective contraception has not been established.
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