title: Migration of intrauterine devices: radiologic findings and implications for patient care.
abstract: Intrauterine devices (IUDs) are a commonly used form of contraception worldwide. However, migration of the IUD from its normal position in the uterine fundus is a frequently encountered complication, varying from uterine expulsion to displacement into the endometrial canal to uterine perforation. Different sites of IUD translocation vary in terms of their clinical significance and subsequent management, and the urgency of communicating IUD migration to the clinician is likewise variable. Expulsion or intrauterine displacement of the IUD leads to decreased contraceptive efficacy and should be clearly communicated, since it warrants IUD replacement to prevent unplanned pregnancy. Embedment of the IUD into the myometrium can usually be managed in the outpatient clinical setting but occasionally requires hysteroscopic removal. Complete uterine perforation, in which the IUD is partially or completely within the peritoneal cavity, requires surgical management, and timely and direct communication with the clinician is essential in such cases. Careful evaluation for intraabdominal complications is also important, since they may warrant urgent or emergent surgical intervention. The radiologist plays an important role in the diagnosis of IUD migration and should be familiar with its appearance at multiple imaging modalities.
authors.affiliation: Department of Radiology, University of California at Los Angeles, Ronald Reagan UCLA Medical Center, 757 Westwood Plaza, Los Angeles, CA 90095, USA. hboortz@mednet.ucla.edu
authors.forename: Hillary E
authors.initials: HE
authors.lastname: Boortz
authors.forename: Daniel J A
authors.initials: DJ
authors.lastname: Margolis
authors.forename: Nagesh
authors.initials: N
authors.lastname: Ragavendra
authors.forename: Maitraya K
authors.initials: MK
authors.lastname: Patel
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Kadell
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology; D000328:Adult; D020878:Device Removal; D004630:Emergencies; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D005315:Fetal Diseases / Q000209:etiology; D005548:Foreign-Body Migration / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007433:Intrauterine Device Expulsion; D007434:Intrauterine Devices / Q000009:adverse effects*; D009215:Myometrium / Q000000981:diagnostic imaging; D010388:Pelvis / Q000000981:diagnostic imaging; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography; D014595:Uterine Perforation / Q000175:diagnosis / Q000209:etiology; D014599:Uterus / Q000000981:diagnostic imaging; D014621:Vagina / Q000000981:diagnostic imaging