ULTRASOUND MONITORING OF PATIENTS WITH INTRAUTERINE DEVICES (IUDS) IN A PUBLIC HOSPITAL IN THE FEDERAL DISTRICT: A RETROSPECTIVE ANALYSIS OF 1,537 EXAMINATIONS
DOI:
https://doi.org/10.56238/arev8n1-072Keywords:
Intrauterine Devices, Ultrasonography, Contraception, Public HealthAbstract
Objective: To evaluate the frequency and efficacy of ultrasound follow-up in patients using intrauterine devices (IUDs), comparing heterotopic positioning rates between ultrasound-guided insertions and blind insertions, and analyzing associated clinical outcomes in a public hospital. Methods: A retrospective observational study conducted at the Regional Hospital of Taguatinga (HRT-DF) between January 2022 and December 2024. A total of 1,537 transvaginal ultrasounds were reviewed, selecting 301 specific exams for IUD evaluation. Patients were stratified into two groups: ultrasound-guided insertion (n=152) and non-guided outpatient insertion (n=149). Outcomes included positioning classification (normopositioned vs. heterotopic), need for repositioning, expulsion, and removal rates. Results: The overall prevalence of heterotopic IUD was 21.3% (64/301). The guided insertion group showed a lower heterotopia rate (19.1%) compared to the non-guided group (23.5%). In the follow-up of 164 returning patients, 29.9% proceeded to device removal and 10.4% required repositioning. Age stratification revealed a higher rate of malpositioning in women ≤29 years (~22%) compared to women ≥30 years (~19%). Conclusion: Ultrasound-guided insertion demonstrated greater accuracy in IUD positioning. Systematic ultrasound follow-up proved essential for early detection of complications, especially in younger women, suggesting the need for monitoring protocols to ensure contraceptive efficacy in the public health network.
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