A missing IUCD is considered when the retrieval strings of certain types of intra-uterine contraception devices are found missing on a 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 IUD is correctly positioned and can often help identify IUD-related complications. Three-dimensional (3D) USG is gaining recognition for its role in imaging IUCD.
Anteroposterior and lateral abdominal radiographys can be helpful in demonstrating an extrauterine IUD.
Rarely computed tomography (CT) is used for the assessment of IUD position. More often IUCD's are incidentally visualized on CT. CT is the best modality for the evaluation of complications associated with intraabdominal IUCDs, such as 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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