It is a condition when the tail of the IUCD is not seen through the os.
1.uterus has enlarged through pregnancy
2.it has been expelled
3.thread has curled inside the uterus
4. perforation has occurred and IUCD is buried in the myometrium
Methods of identification :
1.Plain radiograph or ultrasound to check if IUCD is inside or has been expelled.
2.If it is inside, a uterine sound or another IUCD can be inserted to note it’s proximity to the misplaced IUCD or to note perforation, on radiograph
3.In case of perforation, laparotomy is needed.
4.Hysteroscopy can be used to locate as well as remove the IUCD.
Devices used to remove IUCD:
1 Shirodkar’s hook
4.hysteroscope with ultrasonic guidance.