Displaced intrauterine contraceptive device: a prospective study at tertiary level hospital of Uttarakhand, India

Nidhi Kumari, Vineeta Gupta, Priyanka Chaudhari, Shweta Nimonkar, Archna Tandon


Background: The IUCD is a common method used for contraception. It is associated with complications like bleeding, perforation and migration to neighbouring organs as broad ligament, urinary bladder or omentum.

Methods: A prospective study was carried out at SGRRIM and HS, Dehradun over a period of two years between January 2014 to December 2015. A total of 38 patients with a diagnosis of displaced IUCD were included for their detailed demographic profile, presenting complaints, required diagnostic and therapeutic modalities.

Results: Ultrasound emerged as the preferred method to locate the displaced device. Majority of displaced IUCD were intrauterine (86.9%) and Hysteroscopy guided removal was the preferred method of removal regarding technique, safety, and cost and recovery time.

Conclusions: Responsibility of care provider does not end at insertion of IUCD. Follow up is equally important. Every case of missing IUCD must be investigated carefully to rule out the possibility of uterine perforation.


Hysteroscopy, Intrauterine contraceptive device (IUCD), Perforation

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Heinemann K, Reed S, Moehner S, Do Minh T. Risk of uterine perforation with levonorgestrel-releasing and copper intrauterine devices in the European active surveillance study on intrauterine devices. Contracept. 2015;91(4):274-9.

Andersson K, Ryde-Blomqvist E, Lindell K, Odlind V, Milsom I. Perforations with intrauterine devices: report from a Swedish survey. Contracept. 1998;57(4):251-5.

Houdenhoven VK, Kaam VKJ, Grootheest VAC, Salemans TH, Dunselman GA. Uterine perforation in women using a levonorgestrel-releasing intrauterine system. Contracept. 2006;73(3):257-60.

Mittal S, Kumar S, Roy KK. Role of endoscopy in retrieval of misplaced intrauterine device. Aus New Zealand J Obstet Gynaecol. 1996;36(1):49-51.

Sataa S, Sami BR, sabeur R, Karim C, Ali H. Bladder Calculus resulting from the migration of an intrauterine contraceptive device: a report of ten cases. Nephro-Urology Monthly. 2011;3(1):54-61.

Murphy M. Migration of a Graefenberg ring. Lancet. 1933;222(5755):1369-70.

Andrews CJ. Migrating Gräfenberg contraception ring. JAMA. 1936;107:279.

Ratnam SS, Tow SH. Translocation of the loop. In: Zatuchni GI, editor. Post-partum Family Planning: A Report on the International Program. New York, NY: McGraw-Hill; 1970:371-384.

Alka K, Pradeep G, Sharma M, Agarwal N. Laproscopic removal of extrauterine IUCD using fluoroscopy guidance: a case report. J Gynaecol Surg. 2005;21(1):29-30.

Elahi N, Koukab H. Diagnosis and management of lost intrauterine contraceptive device. J Pak Med Assoc. 2002;52(1):18-20.

Jyoti PS, Geeta J, Vivek S. Misplaced IUCD: etiology and management: a retrospective study, Sch. J Med Sci. 2017;5(4F):1694-7.

Mishra S. Evaluation of safety, efficacy, and expulsion of post-placental and intra-cesarean insertion of intrauterine contraceptive devices (PPIUCD). J Obstet Gynecol India. 2014;64(5):337-43.

Adoni A, Chetrit AB. The management of intrauterine devices following uterine perforation. Contracept. 1991;43(1):77-81.

Braaten KP, Goldberg AP. Malposition IUCD: when you should intervene (and when you should not). OBG Manag. 2012;24:38-46.

World Health Organization. Reproductive Health. Medical eligibility criteria for contraceptive use. World Health Organization; 2010. Available at