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

  • Elysia Moschos
    Correspondence
    Reprints: Elysia Moschos, MD, University of Texas Southwestern Medical Center, Department of Obstetrics and Gynecology, 5323 Harry Hines Blvd., Dallas, TX 75390-9032
    Affiliations
    Division of Gynecology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX
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  • Diane M. Twickler
    Affiliations
    Division of Gynecology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX

    Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
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Published:February 24, 2011DOI:https://doi.org/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.

      Key words

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