EP26.09: Ultrasound‐guided insertion of intrauterine device

To demonstrate the safety and efficacy benefits of ultrasound-guided IUD insertion compared to unguided insertion. A retrospective study from January 2018 to December 2023 compared ultrasound-guided IUD insertion with post-insertion evaluations to non-guided insertion with evaluations after the menstrual cycle. Criteria for inadequate placement included absence of the IUD in the endometrial cavity, low position (>10mm from the superior edge), and myometrial invasion. Z-score test compared the effectiveness of ultrasound-guided versus non-guided insertion. The study compared ultrasound-guided insertion of 288 IUDs in Group 1, confirmed by TV 3D ultrasound at insertion and postmenstrual cycle, to 386 non-guided insertions in Group 2, confirmed by TV 3D ultrasound after the menstrual cycle. In Group 1, 0.7% had the IUD positioned within the endocervical canal, while in Group 2, 1.6% had absent IUDs in the endometrial cavity, confirmed in the abdominal cavity. Additionally, 6.7% of IUDs were located low within the endometrial cavity, and 4.1% involved myometrial invasion, totalling 12.4% with unsatisfactory positioning. A Z-score of < 0.002 indicated significantly higher satisfactory placements with ultrasound-guided insertion of IUDs compared to the non-guided technique. Ultrasound-guided IUDs insertion enhances safety by mitigating risks associated with retroverted uterine position, Müllerian malformations, Caesarean sections, cervical procedures, curettages, and nulliparity. Clear visualization of the sound path is imperative for successful placement, particularly in cases with these complicating factors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.