Intra Uterine Contraceptive Devices may not Always Safe for Women

Although IUDs are well tolerated contraceptive methods, they may result serious complications. Here we presented two uterin perforation cases caused by Cooper T and LNG IUD. The first case is of a 43 years old, G1P1 woman, admitted to the Emergency Department with a sudden severe abdominal pain. On vaginal examination, the distal end side of the IUD had been perforated wall of the cervix and it was protruding outside the uterus. In transvaginal ultrasonography, cervical localized IUD and 74x59 mm in size, heterogeneous mass in the left adnexal area were viewed. Patient underwent laparotomy. Left adnexal tuboovarian abscess were observed and bilateral salpingo-oophorectomy was performed. The second case is of a 33 years old, G4P3A1 patient using levonogestrel IUD. IUD ropes were not observed cervical, after 60 days from application. In ultrasonography, IUD was not observed intrauterine. Diagnostic laparoscopy was performed for patient because she also had chronic pelvic pain. It was observed at the free edge on the posterior aspect of the omentum and it was covered by omentum. Perforation of the uterine wall and migration of IUD to the peritoneal cavity is a rare condition but that may be fatal. Perforation is resulted 1/350-1/2500 after IUD application. Most of these cases are asymptomatic. However, pain, dysmenorrhea, abnormal uterine bleeding can be seen. WHO recommends subtraction of all misplaced IUD's even they are asymptomatic or symptomatic. In conclusion, although IUDs are safe and effective contraceptive methods, but rarely they can cause fatal complications.