Missing Intrauterine Contraceptive Device amongst Clients in Enugu, Nigeria

Abstract

Background
Missing intrauterine contraceptive device (IUCD) is a known complication of IUCD use.
Objective
To examine the methods of diagnosis and Management modalities of missing IUCD at the University of Nigeria Teaching Hospital, Enugu.
Materials and Method
This was a retrospective review of the records of all clients who presented with complaints of missing IUCD over an 11 year period, from 1st January 1990 to 31st December 2000. Relevant information on biodata, methods of diagnosis and removal were extracted and analysed using tabulations and simple percentages.
Results
A total of 44,975 clients were seen at the family planning clinic within the period under review. Twenty two thousand , one hundred and sixty eight clients used IUCD, giving a 55.96% of total contraceptive use. Of these, 20 IUCD missed, giving the incidence of missing IUCD as 0.08%. The mean age of clients with missing IUCD was 38±2.18 years and the mean parity was 6.00 ± 0.54. Majority (30%) were asymptomatic. Twenty five percent
presented with lower abdominal pain. One client had a co-existing pregnancy of about 10 weeks. The commonest mode of diagnosing missing IUCD was the use of plain abdominal x-ray with a marker in-utero (50%) and retrieval hook was used for removal in 45% of the cases. Three patients had exploratory laparotomy for removal of the missing IUCD.
Conclusion
IUCD is a method of contraception most commonly used in UNTH, Enugu .
Plain abdominal x-ray with a marker in-utero is a simple and reliable diagnostic technique for missing IUCD.

Keywords: intrauterine Contraceptive device, missing, Enugu