Document Type : Case Report

Authors

1 Department of Obstetrics and Gynaecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran

2 Students’ Research Committee, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran

3 Students’ Research Committee, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran

Abstract

Although intrauterine devices (IUDs) are known for their low failure rate in pregnancy prevention, potential risks
associated with their use include uterine perforation and migration through the abdomen. In this particular case, the
patient experienced simultaneous IUD failure and perforation, with the device becoming embedded in an omentum. A
28-year-old woman who was 39 weeks plus one day gestation presented for caesarean section. During the caesarean
section, it was discovered that the IUD had entered the omentum through a hole in the posterior part of the uterus.
The result of the birth was a live boy. IUD perforation is most commonly observed during the insertion procedure;
however, it may rarely occur at a later stage. IUD perforations are frequently asymptomatic and remain undetected
until follow-up assessments are conducted or clinical manifestations become apparent. The presence of gastrointestinal
symptoms is commonly observed in cases with intraperitoneal migration of the IUD. Although the occurrence of
abdominal pain, diarrhoea, and fever with a missing IUD are indicative, they may not always be present. Nonspecific
signs and symptoms lead to misdiagnosis and the consequent delay in initiating appropriate treatment. In the present
case, the co-occurrence of IUD embedded in the omentum and pregnancy posed a challenge due to the device’s rapid
and imprecise shift, which complicated its accurate localisation. In such scenarios, ultrasonographic guidance can
serve as a valuable tool to enhance accuracy and decrease adverse outcomes.

Keywords