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Case Report
Intrauterine device displacement into a cesarean section scar
1 BS, Medical Student, Touro College of Osteopathic Medicine – New York, 230 W 125th St, 3rd Floor, New York, New York 10027, USA
2 BS, Ultrasound Technician, Hamptons Gynecology and Obstetrics, Stony Brook Community Medical, 183 West Montauk Highway, Hampton Bays, New York 11946, USA
3 MD, Attending Physician, Clinical Assistant Professor, Department of Obstetrics and Gynecology, Stony Brook University Hospital, Southampton, New York, USA
Address correspondence to:
Minyoung J Park
Touro College of Osteopathic Medicine – New York, 230 W 125th St, 3rd Floor, New York, New York 10027,
USA
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Article ID: 100108Z08MP2022
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Park MJ, King B, Schmitt G. Intrauterine device displacement into a cesarean section scar. J Case Rep Images Obstet Gynecol 2022;8:100108Z08MP2022.ABSTRACT
Introduction: The rate of cesarean section (CS) delivery continues to trend upwards. The popularity of the intrauterine device (IUD) parallels this upward trend. Instances of IUD displacement into a CS scar have been rarely reported. The incidence, effects, and management of such a specific IUD displacement could be worth exploring in both asymptomatic and symptomatic patients.
Case Report: We present a case of IUD displacement into a CS scar in a symptomatic patient. A 41-year-old woman with a surgical history of three cesarean sections presented for a removal and replacement of her levonorgestrel-releasing intrauterine device (LNG-IUD). After an uncomplicated removal and replacement, the patient’s replacement IUD was found displaced at the level of the CS scar via a trans-vaginal ultrasound (TVUS). No further intervention with this replacement IUD occurred due to lack of symptoms.
Two years later, the patient had menstrual irregularities and pelvic pain associated with the IUD displacement, warranting its removal and replacement. In the weeks following this second removal and replacement with a new IUD, the replacement IUD was found displaced once again, but this time displaced into the patient’s CS scar. At this point, the patient opted for an alternative means of contraception. The IUD was to be left in place until her next scheduled appointment. However, the patient canceled the appointment and did not respond to office follow-up. Ten months later, the patient returned to our facility for her IUD removal and informed us that she will not be requiring an alternative contraception method because her partner had received a vasectomy.
Conclusion: Intrauterine device displacement is a phenomenon with an occurrence rate of up to 25% among IUD users. An IUD displacement into the CS scar is an atypical finding that warrants further investigation regarding patient comfort and contraceptive efficacy.
Keywords: Cesarean section scar, Displacement, Intrauterine device
SUPPORTING INFORMATION
Author Contributions
Minyoung J Park - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Brianna King - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Geri Schmitt - Substantial contributions to conception and design, Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Minyoung J Park et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
