THE USE OF VAGINAL ULTRASOUND TO IDENTIFY COPPER-T IUD AT HIGH-RISK OF EXPULSION

A total of 235 women who had a TCu 380A IUD inserted had a vaginal ult rasound scan performed to identify if the IUDs were correctly placed i n the uterine fundus. Women identified as having a misplaced IUD had i t removed. The remaining women were compared to 201 women who had an I UD inserted and had no ultrasound evaluation, matched by age and parit y. Women were followed-up for one year. Gross cumulative discontinuati on rates and continuation rates were calculated by life table analysis . Comparison between groups was done by the Gehan test. The study grou p had 34 IUDs removed because they were misplaced according to the est ablished criteria. The expulsion rate was significantly higher in the control group, also influencing the continuation rate which was lower in the same group. Of the 34 women who had their IUD removed because i t was not correctly placed, only 22 requested and had another IUD inse rted. The removal of IUD determined by an ultrasound to be incorrectly placed significantly decreased expulsion rates. However, many IUDs ma y have been removed unnecessarily, probably resulting in many women no t returning to the clinic or deciding to use another contraceptive met hod. (C) 1996 Elsevier Science Inc.