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  • Title: [Ultra sonography for the localization of intra-uterine contraceptive devices (i.u.d.'s) (author's transl)].
    Author: Meyenburg M.
    Journal: Geburtshilfe Frauenheilkd; 1978 Nov; 38(11):950-7. PubMed ID: 710881.
    Abstract:
    The localization of uterine devices by ultra-sound techniques was investigated. Seven different types of intra-uterine contraceptive devices were checked under immersion in water and in the uterus of 585 wearers of I.U.D.'s. The quality of the ultra-sound pictures is mostly determined by the type of intra-uterine device. Under optimal conditions the investigated types of I.U.D.'s produced standard ultra-sound pictures which permitted their identification. The evaluation of the localization of the intra-uterine contraceptive devices in the uterus was reasonably accurate. At first the classification of normal localization, lower segment localization and cervical localization was used, and this was later enlarged by the measurement of the distance between the uterine fundus and the end of the device closest to the fundus. It was possible to estimate the contraceptive efficiency with these measurements. In 486 cases (83%) the intra-uterine device was found in normal position. In 24 (4.1%) of the cases removal and repeat insertion of the device was suggested. In 18 (3.1%) cases the device was not localized despite normal intra-uterine localization. Ultrasound imaging techniques were used to locate IUDs in 585 women. The copper-T was the most frequent IUD studied (512 cases); others included the Lippes loop, copper-7, progesterone-T, Dalkon shield, Grafenberg ring, and Dana super. Imaging studies were also carried out with IUDs submerged in water. Correct positioning of the IUD was seen in 486 cases. In 57 patients the IUD was too close to, or far from, the cervix; and in 24 it was in the cervix (removal was advised in these cases). Imaging was unsuccessful in 18 cases. In 16 of these, IUDs (IUD pieces in 2 cases) were observed in X-ray photographs; the IUD had been lost in the 2 remaining cases. The distance from the fundus uteri to the nearest end of the IUD varied from 1 to 6 cm in correctly positioned cases; it was usually about 2 cm. Ultrasound image appearance of the devices is described and illustrated.
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