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Clinical Relevance and Symptom Patterns for Malpositioned Intrauterine Devices: A Retrospective Ultrasound-Based
Omar F Dueñas-García1, Jade McGrath2, Mara Walters2
1Department of Obstetrics and Gynecology, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Many intrauterine devices (IUDs) are malpositioned without symptoms, and visible strings do not guarantee correct placement. Pelvic ultrasound is crucial for accurate IUD positioning assessment when concerns arise.
Area of Science:
- Reproductive Health
- Medical Imaging
- Gynecology
Background:
- Intrauterine devices (IUDs) are common contraceptives.
- Accurate IUD placement is essential for efficacy and safety.
- Malposition can lead to complications and reduced effectiveness.
Purpose of the Study:
- To investigate the link between IUD malposition and patient symptoms.
- To identify risk factors for IUD malposition.
- To compare the reliability of string checks versus ultrasound for IUD position.
Main Methods:
- Retrospective chart review of 175 patients with malpositioned IUDs (Jan 2021-Dec 2023).
- Data included demographics, BMI, IUD type, provider, symptoms, and string check findings.
- Pelvic ultrasound confirmed IUD malposition.
Main Results:
- 53.1% of patients with malpositioned IUDs were symptomatic (pelvic pain, abnormal bleeding).
- 46.9% of patients were asymptomatic.
- Low intrauterine placement was the most common malposition; string checks were unreliable.
Conclusions:
- A significant proportion of IUD malpositions are asymptomatic.
- Visible IUD strings do not reliably confirm correct placement.
- Ultrasound is essential for confirming IUD position when clinical suspicion exists.
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