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Ultrasonographically guided intrauterine contraceptive device removal before chorionic villus sampling
A C Ranzini1, R J Wapner, G H Davis
1Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
American Journal of Obstetrics and Gynecology
|August 1, 1995
Summary
Ultrasonographically guided removal of retained intrauterine contraceptive devices in early pregnancy is safe. This procedure can be combined with chorionic villus sampling for genetic testing, offering a streamlined approach for pregnant patients.
Area of Science:
- Reproductive Medicine
- Maternal-Fetal Medicine
- Medical Devices
Background:
- Retained intrauterine contraceptive devices (IUDs) without visible strings during early pregnancy pose management challenges.
- Women using IUDs are often multiparous and may be of advanced maternal age, increasing the complexity of pregnancy management.
Purpose of the Study:
- To describe the experience with ultrasonographically guided retrieval of retained IUDs during the first trimester of pregnancy.
- To evaluate the safety and feasibility of combining IUD retrieval with chorionic villus sampling (CVS).
Main Methods:
- Six patients with first-trimester pregnancies and retained IUDs underwent ultrasonographically guided retrieval using an IUD hook.
- Chorionic villus sampling was offered concurrently or shortly after IUD removal for patients with genetic indications.
Main Results:
- All six IUDs were successfully retrieved under continuous ultrasonographic guidance.
- Four patients underwent CVS immediately after IUD removal; one had CVS 3 weeks later.
- Two pregnancy losses occurred, one post-procedure and one before viability. Remaining infants were structurally normal and born at term.
Conclusions:
- First-trimester ultrasonographically guided IUD retrieval is a safe procedure.
- Combining IUD retrieval with chorionic villus sampling is feasible and can be performed safely in the first trimester.