Intra-uterine contraceptive devices (IUCD) are one of the most frequently used methods of contraception throughout the world. It prevents pregnancy by:
- thinnning the endometrial lining
- preventing sperm motility
- preventing implantation
There are two main types of IUCDs:
- non-hormonal metallic (copper)
- hormonal (e.g. Mirena)
Radiodense intrauterine structures most often 'T-shaped' or at times seen as a serpiginous structure.
- ultrasound is the preferred modality in assessing an IUCD.
- properly placed IUCD may be visualised as a straight hyperechoic structure in the endometrial canal of the uterus and the arms of the IUD extending laterally at the uterine fundus.
- often causes posterior acoustic shadowing.
- the distance from the top of the uterine cavity to the IUCD should be < 3 mm
- distance > 4 mm is more often associated with symptoms such as bleeding and pain, as well as with a higher risk of expulsion or displacement
- in cases where it becomes embedded, a part of it may be visualised within the myometrium.
- if it is located too inferiorly, or if it begins to extend through the cervical os, its effectiveness is decreased and may also cause pelvic pain and/or bleeding. It should be repositioned.
3D ultrasound may be useful to help visualise the IUCD location (especially with serpiginous IUCDs) 4.
Hyperattenuating structures with metallic density.
Treatment and prognosis
- IUCD embedding
- IUCD perforation
- three-fold increase risk of generalised pelvic inflammatory disease (PID)
- pregnancy associated with IUCD
- associated pregnancy with spontaneous abortion
- spontaneous expulsion of IUCD
- IUCD retention
- IUCD fragmentation
History and etymology
The IUCD was first developed by the German physician, Dr. R Richter of Waldenburg.
- 1. Weissleder R, Wittenberg J, Harisinghani MM et-al. Primer of Diagnostic Imaging, Expert Consult- Online and Print. Mosby. (2011) ISBN:0323065384. Read it at Google Books - Find it at Amazon
- 2. Boortz HE, Margolis DJ, Ragavendra N et-al. Migration of intrauterine devices: radiologic findings and implications for patient care. Radiographics. 2012;32 (2): 335-52. doi:10.1148/rg.322115068 - Pubmed citation
- 3. Peri N, Graham D, Levine D. Imaging of intrauterine contraceptive devices. J Ultrasound Med. 2007;26 (10): 1389-401. J Ultrasound Med (full text) - Pubmed citation
- 4. Boortz HE, Margolis DJ, Ragavendra N et-al. Migration of intrauterine devices: radiologic findings and implications for patient care. Radiographics. 2012;32 (2): 335-52. doi:10.1148/rg.322115068 - Pubmed citation
Ultrasound - gynaecology
- ultrasound (introduction)
- acute pelvic pain
- chronic pelvic pain
- Mullerian duct anomalies
- ovarian follicle
- ovarian torsion
- pelvic inflammatory disease
- ovarian cysts and masses
- ovarian cyst
- corpus luteum
- haemorrhagic ovarian cyst
- ruptured ovarian cyst
- ovarian epithelial tumours
- granulosa cell tumours of the ovary
- paraovarian cyst
- polycystic ovaries
- ovarian hyperstimulation syndrome
- post-hysterectomy ovary
- fallopian tube