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Ultrasound-guided repositioning technique for partially expelled intrauterine device: descriptive feasibility study
E M M Yamaguti1, E T Sontag Dos Reis1, W P Martins2
1Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Summary
Ultrasound-guided repositioning of partially expelled intrauterine devices (IUDs) is a feasible and safe outpatient procedure. This technique successfully repositioned IUDs in over 90% of cases without sedation or anesthesia.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Health
- Medical Imaging
Background:
- Partially expelled intrauterine devices (IUDs) can lead to unintended pregnancies and require management.
- Traditional management may involve IUD removal and replacement, or more invasive procedures.
- A minimally invasive, effective repositioning technique is desirable.
Purpose of the Study:
- To evaluate the feasibility and safety of an ultrasound-guided technique for repositioning partially expelled IUDs.
- To assess the success rate, complication profile, and long-term retention of repositioned IUDs.
Main Methods:
- A descriptive feasibility study included 55 women with partially expelled IUDs managed between January 2016 and February 2020.
- IUDs were repositioned to the uterine fundus using Hartmann alligator forceps under real-time ultrasound guidance.
- No sedation, paracervical/intracervical anesthesia, or prophylactic antibiotics were administered.
Main Results:
- Ultrasound-guided repositioning was successful in 51 out of 55 (92.7%) women.
- The procedure was performed by trainees in 87.3% of cases under supervision.
- No uterine perforations or infections occurred within 6 months; 17.6% of repositioned IUDs were expelled within 6 months.
Conclusions:
- Ultrasound-guided repositioning is a safe and feasible method for managing partially expelled IUDs in an outpatient setting.
- The technique offers a high success rate with minimal complications.
- Further studies can explore optimization of retention rates.
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