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  • Title: [Value of ultrasonics in the monitoring of intrauterine devices: apropos of 120 cases].
    Author: Rezgui M, Hajeri F, Ettagorti H, Mahmoud K, Zayani H, Haddad M.
    Journal: Tunis Med; 1985; 63(6-7):390-3. PubMed ID: 4071677.
    Abstract:
    Ultrasound was used in 120 cases to examine women whose IUD strings could not be located during family planning consultations at a clinic in Tunisia. Before the IUD is inserted, ultrasound can be used to determine the exact position of the uterus, identify malformations, locate fibromas, rule out pregnancy, and study the tubes with greater precision. Preliminary ultrasound thus permits identification of contraindications to IUD use. After the IUD is inserted, ultrasound provides more detailed information on the location of the location of the device than either pelvic X-rays or hysterography. The bladder should be full for better analysis of the ultrasound image. 2 kinds of images are created depending on the type of IUD. With copper T devices, the vertical branch is in the form of a continuous, very dense line while the horizontal branch is less dense and may not appear from all angles. The image is similar with a Lippes loop but the dense line is discontinuous. The reported reliability of intrauterine detection of an IUD is almost 100% for all authors. If intraabdominal migration of the IUD has occurred on the long axis of the uterine cavity, the device is easily detected, but if migration was lateral or irregular, the device is more difficult to locate. In 2 cases of intraabdominal migration migration diagnosed by laparoscopy, ultrasound revealed an empty uterus and an image of the device outside the uterine cavity. Ultrasound does not permit diagnosis of common salpingitis, but in all cases of hydro- or pyosalpinx, the image is homogeneous and usually of liquid type, with the IUD visible in the uterus. No other examination can be made in such cases because pelvic infection is an absolute contraindication to all endouterine manipulations. There were 9 cases of pelvic infection in the sample. Ultrasound diagnosis of extrauterine pregnancy is among the most difficult. An empty uterus, a laterouterine image and a liquid image in the pouch of Douglass are highly suggestive of extrauterine pregnancy. 1 case of extrauterine pregnancy occurred; it was suspected on clinical evidence and confirmed by laparoscopy. 6 cases of intrauterine pregnancy were found. When the IUD remains outside the egg, it is usually found almost entirely in the isthmus and cervical canal. Removal is easily accomplished under ultrasound control with no hemorrhagic complications. There were 3 such cases in the series. When the IUD is encrusted in the trophoblast, removal of the device is not recommended unless the patient desires to terminate the pregnancy.
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