From the Research
A low level position of an intrauterine contraceptive device (IUCD) requires prompt medical evaluation and likely repositioning or replacement. This is because a low-lying IUCD can significantly reduce its contraceptive effectiveness and increase the risk of pregnancy, as well as cause symptoms like abnormal bleeding, cramping, pain during intercourse, or vaginal discharge 1. The optimal position of an IUCD is high in the uterine cavity, and any deviation from this position can lead to complications.
Key Considerations
- A low level position of an IUCD can lead to expulsion, displacement, embedment, and perforation 1.
- Ultrasonography is the first-line imaging modality for evaluating IUCD position, particularly in patients with pelvic pain, abnormal bleeding, or absent retrieval strings 1.
- Three-dimensional ultrasonography has proven to be more sensitive in evaluating subtle findings of malposition, particularly side-arm embedment 1.
- Management considerations depend on the severity of the malposition and the presence or absence of symptoms 1.
Recommendations
- Contact your healthcare provider immediately to schedule an appointment if you suspect a low level position of your IUCD.
- Use a backup contraceptive method, such as condoms, until the IUCD is properly repositioned or replaced.
- The repositioning procedure is typically done in an office setting, where your provider will use instruments to adjust the device's position or remove and replace it with a new one.
- Familiarity with the ultrasonographic features of properly positioned and malpositioned IUCDs is essential for accurate diagnosis and management 1.