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宫内节育器的移位

Migration of Intra-Uterine Devices.

作者信息

Verstraeten Victoria, Vossaert Karlien, Van den Bosch Thierry

机构信息

Obstetrics & Gynaecology - UZ Leuven Gasthuisberg, Leuven, Belgium.

Obstetrics & Gynaecology - AZ Sint- Blasius Dendermonde, Dendermonde, Belgium.

出版信息

Open Access J Contracept. 2024 Mar 12;15:41-47. doi: 10.2147/OAJC.S458156. eCollection 2024.

Abstract

Intrauterine devices (IUDs) are a widely used contraceptive. Possible complications from IUDs include failed insertion, pain, vasovagal reaction, infection, abnormal bleeding, and expulsion. Uterine perforation and migration of the IUD are rare complications occurring in approximately 1-2 per 1000 insertions. We executed a systematic review by reviewing all case reports and case series on IUD migration, published between December 2002 and December 2022. Our review indicates that about half of these patients present with pain and that a third are completely asymptomatic. The most common sites of migration are the intestine, bladder, and omentum. We found that the preferred method for removing the migrated IUD is laparoscopy. Generally, there are no lasting injuries after the removal of the migrated IUD, but occasionally, severe complications have been reported. Healthcare providers should be vigilant about this rare complication, especially in cases of painful insertion or the presence of other risk factors for perforation. When uterine perforation is diagnosed, it is advisable to remove the IUD to prevent severe complications.

摘要

宫内节育器(IUDs)是一种广泛使用的避孕方法。IUDs可能的并发症包括放置失败、疼痛、血管迷走神经反应、感染、异常出血和排出。子宫穿孔和IUD移位是罕见的并发症,每1000次放置中约有1 - 2例发生。我们通过回顾2002年12月至2022年12月期间发表的所有关于IUD移位的病例报告和病例系列进行了系统评价。我们的评价表明,这些患者中约一半有疼痛症状,三分之一完全无症状。最常见的移位部位是肠道、膀胱和网膜。我们发现,取出移位IUD的首选方法是腹腔镜检查。一般来说,取出移位IUD后不会有持久损伤,但偶尔也有严重并发症的报告。医疗保健提供者应警惕这种罕见并发症,特别是在放置时疼痛或存在其他穿孔危险因素的情况下。当诊断出子宫穿孔时,建议取出IUD以预防严重并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4307/10944303/804450cf135a/OAJC-15-41-g0001.jpg

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