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Normal Position of IUD

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So here we'll review again, normal positioning,

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not on a PowerPoint, but in an actual case.

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So our sonography here nicely

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labeled the IUD for us right here.

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In this case, this was transabdominal.

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This is actually the bladder bit

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back here, and this is because

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that uterus was flopped anteriorly.

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This is the vagina back here, decompressed

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bladder, and then this is actually the

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body of the uterus and the fundus that

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had flopped anteriorly right here.

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You can see the arms of the IUD.

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So we already have a good idea that it's

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probably going to be in a good, normal location.

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When we go transvaginally, you

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can see some material, some echogenic

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material here in the cervix.

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This is probably going to be the string.

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See, it's sort of melds to the positioning of

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the cervix right here, where as an IUD is not

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going to kind of bend like a string would.

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But important to keep in mind, you want to see

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the rest of the IUD in the right positioning.

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So let's skip through some of these right here.

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And now we have our sagittal view.

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Here's your IUD.

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In this case, we have all that artifact

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and it's causing all the shadow right

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here, but beautifully positioned exactly

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where we expect it to be right here.

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And again, you just go slightly off and you

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lose a lot of that shadowing right there.

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So your cine clips can be really helpful

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to tell you exactly where that is.

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So speaking of that, let's go to our cineclips.

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Here's our sagittal cineclip

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through the uterus right here.

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Come into the uterus right here.

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It's going to be decompressed

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bladder here anteriorly.

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You can already start to see some of the

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artifacts caused by one of the arms of the IUD.

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And there's the rest of it right here.

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And you can see it goes all the way up to

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the tippy top of the endometrium right here.

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So that's good positioning.

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We've confirmed it on the sagittal.

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But let's figure out where those arms are.

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Go back to a transverse,

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a little bit of bladder right here.

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So transverse cine clip right here.

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There's one arm right there.

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There's your other arm right there.

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Little bit of shadowing right there.

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But beautifully positioned.

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Here's the rest of the IUD.

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You can follow that all the way down as well.

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And then we don't even see the

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string necessarily in this image,

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little bits of string down here.

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The string itself, though, doesn't

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matter, it's where the IUD itself is.

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A lot of times, patients may come in for an

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IUD check because they can't feel that string

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anymore, and it's just because it kind of

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got pulled up or bunched up into the cervix.

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That's okay. That's not a problem.

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All that matters really is

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where the IUD itself is.

Report

Faculty

Kathryn McGillen, MD

Assistant Professor of Radiology, Medical Director of Ultrasound

Penn State University Milton S Hershey Medical Center

Tags

Uterus

Ultrasound

Iatrogenic

Gynecologic (GYN)

Cervix

Body

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