What should I do if the IUD is still in place at 25 weeks of pregnancy?

Under normal circumstances, the main management approaches for an intrauterine device (IUD) remaining in place at 25 weeks of pregnancy include close monitoring, IUD repositioning, medication-assisted treatment, mid-trimester IUD removal, and IUD removal after termination of pregnancy. A detailed analysis is as follows:

1. Close Monitoring

If the IUD is not compressing the fetus or placenta and there are no abnormalities such as vaginal bleeding or abdominal pain, a watchful waiting approach may be adopted. Weekly fetal heart rate monitoring and monthly ultrasound assessments of IUD position and fetal development are recommended. Avoid strenuous activities and actions that increase abdominal pressure to prevent displacement of the IUD.

2. IUD Repositioning

When the IUD has shifted but is not embedded, its position can be gently adjusted under ultrasound guidance by a qualified physician to avoid compression on the uterine wall or fetus. After the procedure, bed rest for 2–3 days is advised. Monitor for vaginal discharge, uterine contractions, or other complications, and maintain external genital hygiene to prevent infection.

3. Medication-Assisted Treatment

If mild uterine contractions or slight vaginal bleeding occur due to IUD irritation, medications may be used under medical supervision to alleviate symptoms. Commonly used drugs include progesterone capsules, ritodrine hydrochloride tablets, and magnesium sulfate injection. Fetal heart rate and maternal response must be closely monitored during treatment.

4. Mid-Trimester IUD Removal

If the IUD is compressing the placenta causing impaired blood supply, or if recurrent bleeding or infection occurs, mid-trimester IUD removal is necessary. The procedure is performed under real-time ultrasound guidance using minimally invasive techniques to remove the IUD. Tocolytic therapy is provided afterward, and both fetal heart rate and uterine contractions should be closely monitored.

5. IUD Removal After Termination of Pregnancy

If the IUD severely affects fetal development, significantly increasing the risk of fetal malformations, or causes life-threatening conditions such as severe infection or massive hemorrhage, termination of pregnancy may be required. The IUD is removed during the termination procedure. Postoperative rest is essential, and future fertility plans should be evaluated only after full physical recovery.

In addition, all procedures should be conducted at正规 medical institutions, with strict adherence to medical advice for examinations and treatments. Self-medication should be avoided. Immediate medical attention is required if symptoms such as worsening abdominal pain or heavy vaginal bleeding occur.