Management of an IUD Located in the Cervix

Rationale for Removal

An intrauterine device (IUD) located in the cervix should be removed as soon as possible to prevent complications such as pain, abnormal bleeding, and infection, as recommended by the Centers for Disease Control and Prevention (CDC) 1, 2
IUDs are designed to be positioned properly within the uterine cavity, not in the cervix, according to the CDC 3, 4
Reduced contraceptive efficacy is associated with malpositioned IUDs, including those in the cervix, as reported by the CDC 1, 2

If IUD strings are visible or can be retrieved safely from the cervical canal, the IUD should be removed by gently pulling on the strings, as recommended by the CDC 1, 2
No special instruments are typically needed for cervically located IUDs with visible strings, according to the CDC 1
Ultrasound examination should be performed to confirm the location of the IUD if strings are not visible, as recommended by the CDC 2

After removal, patients should be counseled about alternative contraceptive options if continued contraception is desired, as recommended by the CDC 2, 5
If pregnancy is suspected with a cervically located IUD, evaluation for possible ectopic pregnancy is necessary, and removal reduces risks of spontaneous abortion, septic abortion, and preterm delivery, as reported by the CDC 1, 2

For patients with cervical stenosis or anatomical abnormalities that contributed to the malpositioning, consideration of alternative contraceptive methods is recommended, according to the CDC 3, 6
Patients should be advised to seek care promptly if they experience heavy bleeding, cramping, pain, or abnormal discharge after the procedure, as recommended by the CDC 1, 2