P30.08: The role of 3D transvaginal ultrasound in visualising progesterone releasing intrauterine device

The correct position of an intrauterine device (IUD) is important for routine follow-up after insertion. Copper IUDs are easy to visualise with two-dimensional (2D) ultrasound because of the shadow produced by the copper filament. In hormone releasing IUD difficulties could occur because of the absence of the metallic component and in some cases because of the associated uterine pathology (uterine myome, adenomyosis). The aim of the study was to examine the performance of three-dimensional endovaginal ultrasound in comparison with 2D ultrasound in localisation of hormone releasing IUDs. 50 women with levonorgestrel-releasing intrauterine system were included in the study. 45 (90%) women had levonorgestrel-releasing intrauterine system of 52 mg (Mirena®) and 5 (10%) women had levonorgestrel-releasing intrauterine system of 13.5 mg (Jaydess®). Both devices has the same shape, but Jaydess® has a silver ring just below the transverse arms and just above the hormone reservoir that allows it to be distinguished from Mirena® in utero by ultrasound. We performed 2D ultrasound and thereafter a 3D ultrasound, which enable the visualisation of the coronal plane (Voluson E8, endovaginal probe RIC5-9D). We compared the types of ultrasound as regards the possibility of evaluating the position of the IUD in the uterine cavity. The mean age of the patients was (36 ± 5,3). 2D ultrasound failed to diagnose to correct position of the IUD in 23 cases (46%), while with 3D ultrasound a good visibility was obtained in 48 cases (96%). The silver ring of the Jaydess® IUD was helpful in identifying the device. Both 2D and 3D were useful for diagnosing uterine pathology (myoma and adenomyosis). 3D ultrasound represents a vey useful tool for the assessment for the hormone releasing IUDs.