Intrauterine devices in early pregnancy: findings on ultrasound and clinical outcomes

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 5; pp. 427.e1 - 427.e6
• Main Authors: Moschos, Elysia, MD, Twickler, Diane M., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2011; Elsevier
• Subjects: Adult; Biological and medical sciences; complications of intrauterine devices; Female; Gynecology. Andrology. Obstetrics; Humans; intrauterine device; intrauterine device in pregnancy; Intrauterine Devices; Medical sciences; Obstetrics and Gynecology; Pain - diagnostic imaging; Pregnancy; Pregnancy Trimester, First; Pregnancy, Ectopic - diagnostic imaging; Retrospective Studies; Ultrasonography; complications of intrauterine devices; intrauterine device; intrauterine device in pregnancy; Sonography; Prognosis; Gynecology; Early pregnancy; Contraception; Obstetrics; Ultrasound
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.12.058

Objective The objective of this study was to describe ultrasound findings, clinical symptoms, and outcomes of first-trimester pregnancies with intrauterine devices (IUDs). Study Design This was a retrospective review of 42 women with history of IUD placement and positive serum human chorionic gonadotropin in the first trimester. Results There were 31 intrauterine pregnancies (IUPs), 3 ectopic pregnancies, and 8 pregnancies of unknown location. Of 36 IUDs visualized, 15 were normally positioned and 21 malpositioned. Of 31 IUPs, 8 IUDs were within the endometrium, 17 were malpositioned, and 6 were not seen. Indications included bleeding (14 of 31), pain (12 of 31), and missing strings (5 of 31); 11 had no symptoms. Of 26 IUPs with known pregnancy outcomes, 20 were term deliveries and 6 had failed pregnancies of 20 weeks or less. Conclusion More than half of IUDs identified in the first trimester were malpositioned. IUP was 3 times as likely with a malpositioned or missing IUD. Three quarters of the IUPs with known outcomes had term deliveries. Symptoms were not predictive of IUD malposition.