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IUD thread not felt — DRCOG MCQ

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HardContraceptionIUD thread not feltDRCOG

A 37-year-old with a copper IUD cannot feel the threads after a late period. She had unprotected intercourse 4 days ago and has no pain or bleeding. What is the best immediate management?

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Correct answer: E — Exclude pregnancy and locate the device by ultrasound

The best answer is “Exclude pregnancy and locate the device by ultrasound”. Missing threads require pregnancy exclusion and advice to use alternative contraception until the device is located. Recent unprotected intercourse creates an emergency-contraception decision, and pelvic ultrasound is used to determine whether the IUD is correctly placed, expelled or perforated. Blind instrumentation or immediate reinsertion before location and pregnancy assessment is unsafe.

Reference: CoSRH/FSRH, Intrauterine Contraception: https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-clinical-guideline-intrauterine-contraception-mar-23-amended.pdf