This study was conducted to achieve total of three objectives. The first one was to review management of a series of women referred for removal of IUC with non-visible threads. The second one was to establish whether the device was likely to have been placed at the fundus at insertion. The third and the last one was to document removal success rates in a CSH setting.

This was basicallay a retrospective review. The analysis and review was done of a series of 76 women seen by the author in a specialist CSH clinic for removal of IUC with non-visible threads.

After USS assessment 67 women underwent a removal procedure. 62 devices were successfully removed. Uterine instrumentation beyond the internal os was required in 43 removals, enabling comparison of uterine cavity length with the length of IUC and threads. Such comparison suggested 39/43 devices were not fundal at insertion and that non-visible threads were likely to have been caused by the device moving to the fundus post-insertion under the influence of uterine contractions, leading to retraction of the threads.

The study concluded through its findings that the removal of IUC with non-visible threads can be successfully done in a CSH setting with ultrasound availability. Non-fundal placement of IUC at insertion is likely to be a significant cause of non-visible threads.

Reference: https://srh.bmj.com/content/45/1/44