Ultrasound-guided repositioning technique for partially expelled intrauterine device: descriptive feasibility study

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Yamaguti, EMM
Sontag dos Reis, ET
Martins, WP
Nadai, MN
Soares, NF
Costa, FDS
Vieira, CS
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2022
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Abstract

Objectives: To describe the outcomes of an ultrasound-guided intrauterine device (IUD) repositioning technique without sedation for partially expelled IUDs in our outpatient clinic. Methods: This descriptive feasibility study included data of partially expelled IUDs from patients of our outpatient clinic from January 2016 to February 2020. We repositioned the partially expelled IUDs (IUDs with the vertical arm extending partially or entirely through the cervical canal) at the uterine fundus using a Hartmann alligator forceps under ultrasound visualization. We extracted data from medical records related to the procedure and the 6-month follow-up. The primary outcome was the success rate of the repositioning procedure, defined by ultrasound confirmation of the entire IUD above the internal os. Secondary outcomes included the retention rate of the repositioned IUD at 6 months, expulsion rate of the repositioned IUD within 6 months, and the description of complications. Results: We included data of 55 partially expelled IUD (35 levonorgestrel-IUDs and 20 copper-IUDs) referred to be repositioned. This intervention successfully repositioned 51 IUDs (93%), while the procedure was not completed in 4 patients due to pain. The Obstetrics and Gynecology trainees performed 48 (87.3%) out of 55 procedures. Among the 51 successfully repositioned IUDs, 9 (17.6%) were expelled within six months and 6 patients were lost to follow-up. No uterine perforation or infection-related complications occurred within 6 months of the procedure. Conclusions: The ultrasound-guided IUD repositioning technique seems a safe and feasible approach for partially expelled IUDs. This article is protected by copyright. All rights reserved.

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Ultrasound in Obstetrics and Gynecology

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61

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1

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Subject

Biomedical imaging

alligator forceps

displaced IUD

intrauterine device

partially expelled IUD

ultrasound

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Yamaguti, EMM; Sontag dos Reis, ET; Martins, WP; Nadai, MN; Soares, NF; Costa, FDS; Vieira, CS, Ultrasound-guided repositioning technique for partially expelled intrauterine device: descriptive feasibility study, Ultrasound in Obstetrics and Gynecology, 2022, 61 (1), pp. 109-113

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