Diagnostic Ultrasound - Abdomen and Pelvis

Intrauterine Device
(Left) Longitudinal
endovaginal US shows an IUD
st penetrating the posterior
uterine body myometrium
with only the distal stem
remaining intracavitary.
Shadowing from the IUD
may help to identify its
location when the stem is not
well visualized. (Right)
Transabdominal US shows an
IUD ſt present in the
endometrial canal with
synchronous early intrauterine
pregnancy. The IUD can be left
in place or removed; it is
controversial which is the best
practice at this time.
Diagnoses: Female Pelvis
(Left) Longitudinal
endovaginal US shows a
retroverted uterus with a
cesarean section scar ſt. The
IUD is not seen in the
endometrial cavity. Two subtle
echogenic shadowing foci are
seen near the scar and uterine
serosa . (Right) Transverse
US of the lower uterine
segment in the same patient
shows the IUD stem ſt to
better advantage, perforating
through the cesarean section
scar. Prior cesarean section is
said to not increase the risk of
perforation, but these likely
happen at the time of
placement.
(Left) Longitudinal
endovaginal US shows early
intrauterine pregnancy in a
patient who has an IUD. The
strings were not seen on
clinical exam. An echogenic
focus in the cul-de-sac ſt with
reverberation is seen. (Right)
Transverse endovaginal US of
the cul-de-sac in the same
patient shows the perforated
IUD ſt. When there is a
missing IUD, careful scanning
should be done to locate it. If
not found, a KUB should be
performed as the IUD may be
beyond the FOV of the
transducer.
773