Management of missing threads of IUCD

Introduction: Intra uterine contraceptive device is an effective, reversible and long term method of contraception. The device is made of poly ethylene which is impregnated with barium sulphate to render it radio opaque so that the presence or absence of the device in the pelvis can be easily detected by radiograph or ultrasound. Each device has nylon thread attached to its lower end and this thread protrudes through the cervical canal into vagina. It does not require replacement for long periods. IUCD s have rare but endangering side effects such as uterine perforation.(1) Missing IUCDs may be asymptomatic or present with symptoms. It could be intrauterine, partially embedded in the cavity or extrauterine. Nowadays due to advent of hystero laparoscopy, many of the cases of missing IUCD s are managed easily.(2) Objective: To study the management of misplaced intra uterine device. Materials and Method: It is a Retrospective observational study conducted at a tertiary care hospital from June 2015 to June 2017 for 2 years. Results: In the review of 37 patients with missing IUCD threads, 12 (32.4%) were removed by simple curettage or using IUCD hook under ultrasound guidance, 21 (56.7%) were removed under hysteroscopic guidance, 1 (2.7%) was removed by laparoscopy and 3 (8.1%) were removed by laparotomy. Conclusion: Most of post placental insertion of IUCD s were embedded into uterine myometrium or perforated the uterus and required either endoscopy or laparotomy for removal.   Keywords: Intra uterine contraceptive device, Missing threads