How to manage pregnancy with an intrauterine device (IUD) in place

In cases of pregnancy with an intrauterine device (IUD) in place, continuation of the pregnancy is not recommended for the safety of both the fetus and the mother. Instead, a surgical abortion must be performed to remove both the gestational sac and the IUD. The specific procedure for such an abortion is as follows:

1. If the patient’s IUD has migrated downward into the cervical canal or is about to expel spontaneously, the IUD will first be removed prior to performing the abortion procedure. Once the IUD is removed, the standard surgical abortion can proceed normally.

2. If the IUD remains within the uterine cavity, the gestational sac and decidua may partially or fully embed it. In such cases, a suction cannula is first used to aspirate the gestational sac and decidua. Following this aspiration, residual intrauterine tissue is significantly reduced, thereby exposing the IUD. A uterine sound may then be used to locate the IUD, after which an IUD removal hook can be employed to safely extract it.

3. Postoperative care is essential: sexual intercourse must be avoided for one month following the procedure.

Women using an IUD who experience any signs or symptoms suggestive of pregnancy should promptly seek evaluation at a reputable obstetrics and gynecology hospital and clearly inform their healthcare provider of their IUD use, so that an appropriate management plan can be formulated.