A missing IUCD is considered when the retrieval strings of certain types of intra-uterine contraception devices cannot be seen on physical examination.
The possibilities are
- expulsion of IUCD
- migration of IUCD
- detachment of IUCD thread
- uterine perforation in IUCD
- embedded IUCD
Ultrasound is appropriate for initial evaluation and can provide answers to clinical questions related to the IUCD. It easily helps determine whether an IUCD is correctly positioned and can often help identify IUCD-related complications. Three-dimensional (3D) US is gaining recognition for its role in imaging IUCDs.
Anteroposterior and lateral abdominal radiographs can be helpful in demonstrating an extrauterine IUCD.
Rarely computed tomography (CT) is used for the assessment of IUCD position. More often IUCDs are incidentally visualised on CT. CT is the best modality for the evaluation of complications associated with intra-abdominal IUCDs, e.g. visceral perforation, abscess formation, and bowel obstruction.
MRI is not typically used for evaluation of IUCD, but modern IUCDs are safely imaged with MRI and appear as signal voids.
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