title: Intrauterine devices in early pregnancy: findings on ultrasound and clinical outcomes.
abstract: OBJECTIVE
  The objective of this study was to describe ultrasound findings, clinical symptoms, and outcomes of first-trimester pregnancies with intrauterine devices (IUDs).
  
  
  METHODS
  This was a retrospective review of 42 women with history of IUD placement and positive serum human chorionic gonadotropin in the first trimester.
  
  
  RESULTS
  There were 31 intrauterine pregnancies (IUPs), 3 ectopic pregnancies, and 8 pregnancies of unknown location. Of 36 IUDs visualized, 15 were normally positioned and 21 malpositioned. Of 31 IUPs, 8 IUDs were within the endometrium, 17 were malpositioned, and 6 were not seen. Indications included bleeding (14 of 31), pain (12 of 31), and missing strings (5 of 31); 11 had no symptoms. Of 26 IUPs with known pregnancy outcomes, 20 were term deliveries and 6 had failed pregnancies of 20 weeks or less.
  
  
  CONCLUSIONS
  More than half of IUDs identified in the first trimester were malpositioned. IUP was 3 times as likely with a malpositioned or missing IUD. Three quarters of the IUPs with known outcomes had term deliveries. Symptoms were not predictive of IUD malposition.
authors.affiliation: Division of Gynecology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, 75390-9032, USA. elysia.moschos@utsouthwestern.edu
authors.forename: Elysia
authors.initials: E
authors.lastname: Moschos
authors.forename: Diane M
authors.initials: DM
authors.lastname: Twickler
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007434:Intrauterine Devices; D010146:Pain / Q000000981:diagnostic imaging; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014463:Ultrasonography