Successful retrieval of an intrauterine device with "missing strings" using a manual vacuum aspirator in a desired early pregnancy: case report.

Intrauterine pregnancy in the presence of an intrauterine device (IUD) is a rare event. If the pregnancy is desired, IUD removal must be negotiated so that the risk of pregnancy disruption is minimized. Cases in which the IUD strings are "missing" present further challenges. We report successful removal of a copper T380A IUD with missing strings using a hand-held manual vacuum aspirator in the setting of a desired pregnancy. Under real-time abdominal ultrasound guidance, the IUD was removed from the lower cervical canal using a 6-mm cannula attached to a manual vacuum aspirator. Fetal cardiac activity was undisturbed throughout the procedure. The patient subsequently delivered a healthy full-term infant via spontaneous vaginal delivery. Manual vacuum aspiration, a simple office-based procedure, may be a useful approach to removal of an IUD with missing strings.