Evaluation of uterocervical angle in intrauterine device displacement cases

Intrauterine device is one of the most preferred birth control method in the world. Being able to predict that the intrauterine device will not dislocate is very important in terms of preventing unwanted pregnancies. Here, we evaluated the role of uterocervical angle in displacement of intrauterine device and to determine whether it has a discriminative role for displacement.

This cross-sectional case-control study was conducted at an obstetrics and gynecology clinic of a university-affiliated training and research hospital. A total of 108 patients between June 2021 and September 2021 were included. While 36 patients in the case group had intrauterine device displacement, 72 patients in the control group had normal intracavitary intrauterine device detected under transvaginal ultrasound. Demographic characteristics, parameters related to intrauterine device and uterus were recorded. Uterocervical angle was measured in all the patients.

There was no statistically significant difference in terms of sociodemographic features, parameters related to uterus size and intrauterine device. The median uterocervical angle was significantly higher in intrauterine device displacement group as compared to controls [159.5 (90-177) vs 146 (118-169) degrees, p < 0.001)]. Uterocervical angle > 156 degree discriminates intrauterine device displacement with 66.67% sensitivity and 80.56% specificity (AUC = 0.763).

A larger uterocervical angle may suggest an increased likelihood of intrauterine device displacement. Thus, uterocervical angle seems to have a potential to play a crucial role in the monitoring and management of intrauterine device users even in patients with similar sized uterus.