Journal of South Asian Federation of Obstetrics and Gynaecology

Register      Login

VOLUME 12 , ISSUE 3 ( May-June, 2020 ) > List of Articles

RESEARCH ARTICLE

Analysis and Management of Missing Intrauterine Contraceptive Device Threads in a Tertiary Care Hospital

Setu Rathod, Sunil Kumar Samal

Keywords : Family planning, Hysteroscopy, Missing intrauterine contraceptive device, Ultrasound

Citation Information : Rathod S, Samal SK. Analysis and Management of Missing Intrauterine Contraceptive Device Threads in a Tertiary Care Hospital. J South Asian Feder Obs Gynae 2020; 12 (3):163-166.

DOI: 10.5005/jp-journals-10006-1784

License: CC BY-NC 4.0

Published Online: 22-11-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Intrauterine contraceptive devices (IUCDs) are a common method of contraception adopted for birth spacing in India. Copper T (CuT) 380A is marketed by the government free of cost, which makes it widely available to the patients in need. But a common problem of missing threads leads to an unwanted complication, which needs to be analyzed. Materials and methods: This is a retrospective analysis of patients with missing CuT threads attending the outpatient department (OPD) of gynecology of Mahatma Gandhi Medical College, Puducherry, over a 3-year period between 2017 and 2019. Data regarding patients complaints, timing and place of insertion, obstetric history, ultrasound report, and method of retrieval were analyzed. Results: Out of 75 users of IUCD attending OPD of gynecology over the last 3 years, 28 patients came with missing IUCD threads. Out of 28, 2 patients had spontaneous expulsion, 6 opted for continuation after confirming its normal placement within the uterine cavity, whereas 20 patients opted for retrieval. The most common reason for removal was the need for conception (60%). In 46.4% of cases, IUCD was found embedded in the myometrium and 50% required diagnostic hysteroscopy. Use of ultrasound during retrieval helped in around 50% of cases. Difficulty in retrieval was seen in two cases whereas perforation was seen in one case. Conclusion: Most of the missing IUCD threads were found in patients with history of previous cesarean and though ultrasound in most cases revealed IUCD within the uterine cavity, in few cases it was embedded in the myometrium making retrieval difficult requiring an OT setup.


PDF Share
  1. Intrauterine devices and risk of uterine perforation: Current perspectives. Open Access J Contracept 2016;7:19–32. DOI: 10.2147/OAJC.S85546.
  2. World Contraceptive Patterns 2013. New York: United Nations Department of Economic and Social Affairs; 2015. http://www.un.org/en/development/desa/population/publications/family/contraceptive-wallchart-2013.shtml.
  3. https://nrhm.gujarat.gov.in/images/pdf/IUCD_Reference_Manual_Nursing_Personnel.pdf.
  4. Intrauterine contraceptive device (IUCD): Socio-demographic characteristics of acceptors, acceptability and effectiveness in a teaching hospital in Nigeria. Niger J Med 2001;10(1):14–17.
  5. Intrauterine Contraceptive Device in Family Planning Method and Practices in Africa. 3rd ed., Atlanta Georgia: CDC;; 1983.
  6. Complications of intrauterine contraceptive device (IUD) use at the university of Ilorin teaching hospital, Ilorin. Niger J Med 2004;13(3):244–249.
  7. Missing IUCD strings: an analysis. Int J Reprod Contracept Obstet Gynecol 2018;7:4061–4067.
  8. Missing intrauterine contraceptive device string: diagnosis and management at federal medical center Bida, Northcentral, Nigeria. Trop J Obstet Gynaecol 2018;35(3):298–303. DOI: 10.4103/TJOG.TJOG_56_17.
  9. Tail of the tails. the missing post-partum IUCD strings. J Obstet Gynaecol India 2017;67(3):202–207. DOI: 10.1007/s13224-016-0940-9.
  10. Diagnosis and management of misplaced intrauterine contraceptive device (IUCD). Pak J Surg 2010;26:151–154.
  11. Knowledge, attitudes and practice of family planning amongst women in Ibadan Nigeria. Trop Obstet Gynaecol 1985;5:19–26.
  12. Malpositioned IUDs: when you should intervene (and when you should not). OBG Management 2012;24(8):39–46.
  13. Misplaced IUCD: challenges and management. People's J Sci Res 2016;9(2):14–17.
  14. The width of the uterine cavity is narrower in patients with an embedded intrauterine device (IUD) compared to a normally positioned IUD. J Ultrasound Med 2010;29(10):14536. DOI: 10.7863/jum.2010.29.10.1453.
  15. Long acting reversible contraception: implants and intrauterine devices. Practice bulletin no. 121. Obstet Gynecol 2011;118(1):184–196. DOI: 10.1097/AOG.0b013e318227f05e.
  16. Migration of intrauterine devices: radiologic findings and implications for patient care. Radio Graphics 2012;32(2):335–352. DOI: 10.1148/rg.322115068.
  17. Transuterine migration as a complication of intrauterine contraceptive devices: Six case reports. Eur J Contracept Reprod Health Care 2004;9(3):194–200. DOI: 10.1080/13625180400007165.
  18. Laparoscopic retrieval of perforated intrauterine device. Niger J Clin Pract 2008;11(4):394–395.
  19. Diagnosis and management of lost intrauterine contraceptive device. J Pak Med Assoc 2002;52(1):18–20.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.