The use of transvaginal ultrasonography compared to routine gynecological examination to check the location of an intrauterine contraceptive device.

The objective of this study was to evaluate the use of transvaginal ultrasonography compared with a routine gynecological examination to check the location of an intrauterine contraceptive device (IUCD). Fifty-two women attending the antenatal cure unit at Lundby hospital for contraceptive guidance were included in the study. All women had an IUCD inserted at this visit and were examined bimanually and by speculum. The same examination was repeated and a transvaginal ultrasound scan was carried out at 1 week and then 3 months later. In 51 women, the threads of the device could be identified at the time of the gynecological examination and the IUCD was considered to be correctly positioned. In one woman, the threads could not be seen, but transvaginal ultrasonography confirmed that the position of the device was at the fundus of the uterus. Forty-eight women were judged by ultrasound examination to have the device optimally placed in the uterine cavity. In four women, although the IUCD was apparently correctly located according to the gynecological examination, the device was shown by ultrasonography to be misplaced.We suggest that transvaginal ultrasonography should replace the conventional gynecological examination as the best method of checking the location of an IUCD. Copyright 1994 International Society of Ultrasound in Obstetrics and Gynecology