Ultrasonic localization of the Lippes loop

Abstract

Ultrasound B-mode scanning was performed on 55 patients complaining of a missing nylon string, after a Lippes loop had been inserted from 2 months to 3 years previously. Of these patients, 44 had the intrauterine contraceptive device (IUCD) in place; 5 had unnoticed spontaneous expulsion; 2 had uterine perforation, one of which was associated with an early gestation; one patient had the IUCD imbedded in the anterior uterine wall; one patient had a broken Lippes loop; and two patients had an intrauterine device in place, associated with pregnancy. The localization of the missing IUCD by ultrasound B-scanning was correct in all cases and confirmed by hysterosalpingogram. In cases of complete or incomplete uterine perforation, the diagnosis was proved at laparotomy. For the absence of ionizing radiation, ultrasound B-mode scanning should be used when the possibility of a coexistent intrauterine pregnancy is suspected.