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Annual sonograms are needed to verify correct IUD position, UT Southwestern obstetricians say
Date:3/29/2011

DALLAS March 29, 2011 A retrospective study of women who became pregnant while using intrauterine devices shows that more than half of the IUDs were malpositioned.

Though the displacement may have occurred over time, a UT Southwestern Medical Center researcher suggests that routine sonograms after IUD placement would in the least confirm proper initial positioning.

"Gynecologists typically do a pelvic and speculum exam after placing an IUD, but there's no sonogram involved," said Dr. Elysia Moschos, associate professor of obstetrics and gynecology and lead author of the study, available online and planned for the May issue of the American Journal of Obstetrics & Gynecology. "Based on the results of our study, we believe that sonographic evaluation of IUDs after insertion and for surveillance should be a topic of ongoing consideration."

In the retrospective study of 42 women with IUD placement and a positive pregnancy test, 36 had IUDs that were visualized through ultrasound and 2D imaging. Fifteen of these IUDs were normally positioned, and 21 were malpositioned.

Dr. Moschos said obstetricians and gynecologists should consider sonograms as part of the protocol after IUD insertion and possibly schedule them annually for those with IUDs, which can remain in the body for up to 10 years.

IUDs are a highly effective form of birth control, and pregnancy rates are extremely low. In the rare cases where women do become pregnant while using an IUD, transvaginal sonography during the first trimester can reduce complications by determining the pregnancy and IUD location, as well as whether the device can be retrieved.

Pregnancies complicated by an IUD's presence are at increased risk for first- and second-trimester miscarriage or preterm delivery if the device is left in place. While removing the IUD reduces these risks, the removal process itself carries a small risk of miscarriage.

In the study, 31 women h
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Contact: Robin Russell
robin.russell@utsouthwestern.edu
214-648-3404
UT Southwestern Medical Center
Source:Eurekalert

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