Incarcerated and Transmigrated Intrauterine Contraceptive Devices Managed at a Tertiary Care Teaching Hospital of East Delhi: A 5-Year Retrospective Analysis.J Obstet Gynaecol India 2019; 69(3):272-278JO
Purpose of the Study
Intrauterine contraceptive devices (IUCDs) are highly effective form of long-acting reversible contraception having least number of complications. We aimed to find the incidence, risk factors and the management done for incarcerated and transmigrated intrauterine contraceptive devices at a Tertiary Care Teaching Hospital during past 5 years.
A cross-sectional retrospective analysis of 5 years (January 2013-December 2017) was done, and the case records from Medical Record Department and Family Planning Unit of our institution were analysed.
Total number of IUCD insertions done in last 5 years (from January 2013 to December 2017) in our institution was 4557. Misplaced IUCDs requiring surgical interventions were 71 (1.6%) out of which 63 (88.7%) were incomplete perforations or embedded and 8 (11.3%) were complete perforations or transmigrated IUCDs. Transmigration sites were omentum, uterovesical fold, mesentery and bladder. Laparotomy was needed in 4 (5.6%), and 2 (2.8%) needed each laparoscopy and cystoscopy. Main risk factors identified were postpartum previous on or two caesarean sections, low parity, grade of operator and IUCD and uterocervical length discrepancy.
The risk of perforation should not be a reason to defer IUCD insertion and every effort should be made to bring down its failure and complication rates.