From the Guidelines
IUD strings should be trimmed to approximately 10-12 cm in length immediately after insertion, as this length allows for proper placement and reduces the risk of expulsion, and can be further trimmed at a follow-up visit if necessary. When trimming IUD strings, it is essential to follow proper technique to minimize the risk of complications, such as infection or accidental displacement of the device 1. The procedure involves removing the IUD from the inserter, cutting the strings to the desired length, and then inserting the device through the cervix using ring or Kelly placental forceps.
- Key considerations for trimming IUD strings include:
- Using sterile gloves and equipment to minimize the risk of infection
- Cutting the strings to the correct length to allow for proper placement and minimize the risk of expulsion
- Visualizing the cervix and uterine fundus to confirm correct placement of the device
- Avoiding excessive traction on the strings, which can cause discomfort or displacement of the device
- It is crucial to note that IUD strings should only be trimmed by a qualified healthcare provider, as improper technique can lead to complications, and patients should never attempt to trim their own IUD strings 1. After trimming, patients can check for the presence of the strings by inserting a clean finger into the vagina to feel for the threads near the cervix, providing reassurance that the IUD remains properly positioned.
From the Research
Trimming IUD Strings
- The provided studies do not directly address the trimming of IUD strings.
- However, a study by 2 describes a procedure for performing a loop electrosurgical excision procedure (LEEP) without removing the IUD, which involves securing a 0-polyglactin free tie around the visible portion of the IUD strings and then cutting the suture close to the polyglactin knot after the procedure, making certain not to shorten the IUD strings.
IUD Placement and Removal
- Studies 3, 4, 5, and 6 discuss various aspects of IUD placement and removal, including the use of ultrasound for detection and removal of abnormally located IUDs, hysteroscopic removal of IUDs, and the relationship between uterine dimensions and IUD malposition.
- These studies do not provide information on trimming IUD strings, but rather focus on the placement, removal, and management of IUDs.
Ultrasound and IUDs
- Studies 3, 4, 5, and 6 highlight the importance of ultrasound in the evaluation and management of IUDs, including the detection of abnormally located IUDs and the assessment of uterine dimensions.
- While ultrasound is a valuable tool in the management of IUDs, it is not directly related to the trimming of IUD strings.