Use of ultrasound in levonorgestrel intrauterine device insertion and control

Abstract

Objectives: To evaluate the efficacy of insertion of levonorgestrel intrauterine devices LNG-IUD guided by ultrasound as a procedure that avoids the improper positioning of the device and reduces the prevalence of complications described in the literature. Patients and Methods: Retrospective analysis of ultrasound images of 608 medical records of patients who underwent insertion of LNG-IUD guided by ultrasound, in the period from January 2002 to January 2012, in Ecoclínica Clínica de Ecografia in the city of Curitiba, Paraná. We evaluated and compared the images from the time of insertion and the images of the control examination performed one year after the procedure. All images were obtained by the same sonographer, and all patients signed an informed consent. Results: No drilling or low insertion of the device were observed during the insertion thereof. Spontaneous expulsion of the LNG-IUD was observed in a period of 5 days up to 90 days after insertion in five cases (0.82%). Control examination showed that in four cases, device migration to the myometrium and into the abdominal cavity (0.65%) and in 28 cases, the evaluation took place one year after the device was below the ideal position (4.6%). Conclusions: The insertion of levonorgestrel intrauterine devices guided by ultrasound as a routine procedure prevents the inappropriate positioning of the device and reduces the prevalence of complications such as uterine perforation.