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Indian Journal of Obstetrics and Gynecology

Volume  7, Issue 3, July-September 2019, Pages 395-398
 

Original Article

Study of Missing Strings of Intrauterine Contraceptive Devices

Manjula HM1, Neeraja TS2, Ramesh G3

1,2Assistant Professor, 3Professor & Head, Dept of Obstetrics and Gynecology, The Oxford Medical College, Hospital & Research Center, Yadavanahalli, Bangalore, Karnataka 562107, India

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.7319.7

Abstract

Introduction: Intrauterine Contraceptive device is an effective, safe and convenient method of contraception used worldwide. It may have complications like missing threads, abnormal uterine bleeding, perforation and migration to neighbouring structures. The device has nylon thread attached to its lower end and this thread protrudes through cervical canal into vagina. Missing strings of IUCD is a common complaint, among IUCD Users with, possibilities of spontaneous expulsion or it could be intrauterine, Partially embedded in the myometrium or trans migration to extra uterine structure. With the invent of hysterolaparoscopy missing strings of IUCD can we managed easily. Objectives: To analyze the factors associated with the missing strings of IUCDs’. To review the management of missing strings of IUCD Materials and Methods: This is a Prospective observational study conducted in the department of OBG at Oxford Medical College, Hospital and Research Centre, Yadavanahalli, Bangalore, from Jan 2017–2018. Results: In our study there were 46 cases of missing strings of IUCD found over a period of 1 year, with a common type being Cu T 380A and multi load. Out of 46 cases 78% of cases IUCD was Inserted by lady health worker/PHC doctor. Majority of the patients had a time interval of 2-5 years between the insertion and removal of IUCD. 80% of the cases (37 patients) IUCD was intrauterine, 10% of cases (5 patients) it was partially embedded in the myometrium and only 6.5% cases (3 patients) IUCD was situated extra uterine sites. Missing IUCD was removed easily with simple artery forceps/IUCD hook in 28 cases (60%), 14 cases required hysteroscopy and 3 cases laparoscopy was needed for the retrieval. Conclusion: Hence, IUCDs is a safe and cost effective method of contraception in the developing countries. Proper education and counseling of the beneficiaries regarding the regular follow up is required for early removal of misplaced IUCD. Institutional training of the family planning personnel is necessary for proper insertion to avoid complications. Hysteroscopy guided retrieval of the misplaced IUCD is the Gold Standard.


Keywords : IUCD; Missing strings; Uterine perforation transmigration; Hysteroscopy.
Corresponding Author : Manjula HM