Commentary| Volume 88, ISSUE 3, P330-333, September 2013

Controversies in family planning: desired pregnancy, IUD in situ and no strings visible

      We recently saw a 29-year-old G2P1001 who is 8 weeks pregnant with her copper 380A intrauterine device (IUD) embedded in her cervix. The IUD was placed 7 years ago at an outside facility. On transvaginal ultrasound, the IUD is at least partially in the cervical stroma, not in the canal itself, and appears to be at an angle with one arm in the left portion of the cervix and the remainder in the anterior stroma. This is a desired pregnancy. She has had three attempts at IUD removal, including one with us which was extensive and unsuccessful. I am curious what your thoughts are about removal options (or nonremoval options). What are your thoughts about hysteroscopic removal and continuing the pregnancy? Any thoughts on the risks of local anesthetic/vasopressin to a continuing pregnancy?
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