Elysia Moschos1, Diane M Twickler. 1. Division of Gynecology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, 75390-9032, USA. elysia.moschos@utsouthwestern.edu
Abstract
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.
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.
Authors: Jason D Bell; Ingrid L Bergin; Melissa F Natavio; Fatima Jibrel; Melissa K Zochowski; William J Weadock; Scott D Swanson; David M Aronoff; Dorothy L Patton Journal: Contraception Date: 2012-10-29 Impact factor: 3.375