Outcome of removal of intrauterine devices with flexible hysteroscopy in early pregnancy.

Abstract

Removal of intrauterine devices (IUDs) in early pregnancy, when the IUDs threads are not visible at the cervical canal and the patient wishes to continue her pregnancy, remains a problem. Thirty-three patients using IUDs with nonvisible filaments on examination underwent flexible hysteroscopy for retrieval of the devices and follow-up until delivery. In all cases, hysteroscopies were performed without cervical dilatation and anesthesia. In 30 patients, the devices were found within the uterine cavity, and 28 IUDs were removed. In the remaining 3 patients, no IUD was observed. Twenty-four healthy children have been born. Six other patients requested a dilatation and curettage (D & C) about 1-2 weeks later after successful IUD removal. In 2 women, examinations were done at 22 and 29 weeks antepartum, and these 2 patients were lost to follow up. Operative fiberoptic hysteroscopy is proposed as a useful and effective method of retrieval of IUDs in early pregnancy when the filaments of the IUD are absent.