Question 17: Perforate IUCD

Question 1

What is shown?

Answer 1

Perforated IUD (Intrauterine Device)

Question 2

Why did the sister order it?

Answer 2

To locate the IUD, as the strings could not be found during attempted removal.

Possible reasons include:
The patient became pregnant while the IUD was in place.
Pelvic pain and suspicion of IUD migration or perforation.

Question 3

What are the common symptoms or presentation of perforated IUD?

Answer 3

Heavy bleeding
Severe cramping
Abnormal vaginal discharge

Question 4

What are the risk factors for IUD perforation?

Answer 4

IUD placement by an inexperienced clinician
An immobile or retroverted uterus
IUD insertion immediately after childbirth

Question 5

What investigations may be ordered?

Answer 5

AXR (Abdominal X-ray) or Ultrasound (USS) to locate the IUD and confirm if perforation has occurred.

Question 6

What is the treatment for a perforated IUD?

Answer 6

Removal of the IUD through laparoscopic or laparotomy surgery.

Question 7

What should be done for future contraception?

Answer 7

If unprotected intercourse occurred since the previous menstruation, emergency contraception may be required.
Advise the patient to use condoms until the IUD is removed.
Discuss future contraception methods and initiate a new method after IUD removal.