IUD and the IUS are widely used forms of long-acting reversible contraception. Occasionally, IUD/IUS users have an ultrasound scan that shows a low-lying IUD/IUS, or an IUD/IUS is found incidentally on scan to be low-lying within the uterus. No formal guidelines exist on the clinical implications of this scenario or the most appropriate management. Researchers conducted this research to report here on a systematic review of the literature.

The researchers performed a search of the online database PubMed to identify articles relating to low-lying or malpositioned IUD/IUS.

After the literature search, a total of 1101 articles was identified. After the initial screening, only 15 were determined to be relevant to the research question.

The study concluded that there is little published evidence to determine the clinical relevance of a low-lying IUD. The findings recommend that the individualized management of these women, with particular caution in younger women and those with a history of previous IUD/IUS expulsion. Consideration may be given to attempting to readjust the IUD/IUS position. Immediate replacement is essential if removal is performed and the provision of alternative effective contraception has not been established.

Reference: https://srh.bmj.com/content/40/2/108