3D Modeling of a Myometrially Embedded Intrauterine Device

To describe a novel technique for visualizing deeply embedded intrauterine devices (IUDs) using three-dimensional (3D) models generated from standard ultrasound imaging, and to demonstrate how these models enhance perioperative planning and patient counseling and understanding.

A single-site academic tertiary care medical center.

A 31-year-old G2P1011 presented with a deeply embedded levonorgestrel IUD placed six weeks postpartum after cesarean delivery. Multiple removal attempts failed due to deep myometrial embedment.

Longitudinal transvaginal ultrasound images (403 slices) were used to construct a volumetric dataset. Using 3D modeling software, the volume was segmented into labeled regions; thresholding isolated the uterus and IUD based on pixel intensity, enabling precise spatial analysis. Noise reduction and translucency adjustments improved visualization of IUD depth and orientation. The patient-specific 3D model was then incorporated into a structured counseling session.

With increasing global IUD use and recognition of malposition and deep embedment, there is a need for adjunctive tools to complement established imaging modalities [1]. In the absence of dedicated 3D ultrasound, reconstruction of a patient-specific 3D model from existing 2D ultrasound data using open-source software was technically feasible in this single case and aided both surgical planning and patient counseling [2]. Clinical 3D ultrasound remains the preferred modality when available, but 2D-derived 3D modeling may serve as a niche adjunct when repeat imaging is undesirable and existing datasets can be leveraged. Deeply retained or fractured IUDs are unpredictable, often requiring complex surgical planning with hysteroscopic, laparoscopic, or combined approaches [3-5] Further comparative studies are needed to assess reproducibility, practicality, and impact on clinical outcomes. VIDEO ABSTRACT.