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Low-lying or malpositioned intrauterine devices and systems
Ellen Golightly1, Ailsa E Gebbie
1Specialist Registrar, Department of Obstetrics and Gynaecology, Royal Infirmary of Edinburgh, Edinburgh, UK.
The Journal of Family Planning and Reproductive Health Care
|January 8, 2014
Summary
A low-lying intrauterine device (IUD) or intrauterine system (IUS) requires individualized management due to limited evidence on its clinical relevance. Clinicians should consider repositioning or replacing the IUD/IUS, especially in younger patients or those with prior expulsion history.
Area of Science:
- Reproductive Health
- Contraception Technology
- Gynecological Imaging
Background:
- Intrauterine devices (IUDs) and intrauterine systems (IUS) are common long-acting reversible contraceptives.
- A low-lying IUD/IUS on ultrasound may be detected incidentally or during routine follow-up.
- Current clinical guidelines for managing low-lying IUDs/IUSs are lacking.
Purpose of the Study:
- To systematically review the literature regarding the clinical implications and management of low-lying intrauterine devices (IUDs) and intrauterine systems (IUSs).
Main Methods:
- A comprehensive literature search was conducted using the PubMed database.
- The search focused on identifying articles related to low-lying or malpositioned IUDs/IUSs.
- Relevant articles were selected based on their applicability to the research question.
Main Results:
- An initial search identified 1101 articles.
- Fifteen articles were deemed relevant for inclusion in the systematic review.
- The available literature provides limited evidence on the clinical significance of a low-lying IUD/IUS.
Conclusions:
- Management of a low-lying IUD/IUS should be individualized, considering patient factors.
- Particular caution is advised for younger women and those with a history of IUD/IUS expulsion.
- Repositioning the IUD/IUS may be considered; if removed, immediate replacement is crucial if alternative contraception is not established.
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