{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:28:59Z","timestamp":1761676139962,"version":"3.44.0"},"reference-count":19,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Fam Plann Reprod Health Care"],"accepted":{"date-parts":[[2013,11,12]]},"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The intrauterine device (IUD) and intrauterine system (IUS) are widely used forms of long-acting reversible contraception. Occasionally, IUD\/IUS users have an ultrasound scan that shows a low-lying IUD\/IUS or an IUD\/IUS is found incidentally on scan to be low-lying within the uterus. No formal guidelines exist on the clinical implications of this scenario or the most appropriate management. We report here on a systematic review of the literature.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A search of the online database PubMed was performed to identify articles relating to low-lying or malpositioned IUD\/IUS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 1101 articles was identified, and 15 were determined to be relevant to the research question.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>There is little published evidence to determine the nature and extent of the clinical relevance of a low-lying IUD. We recommend individualised management of these women, with particular caution in younger women and those with a history of previous IUD\/IUS expulsion. Consideration may be given to attempting to readjust the IUD\/IUS position, but if removal is performed, immediate replacement is essential if provision of alternative effective contraception has not been established.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jfprhc-2013-100684","type":"journal-article","created":{"date-parts":[[2014,1,6]],"date-time":"2014-01-06T21:27:55Z","timestamp":1389043675000},"page":"108-112","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Low-lying or malpositioned intrauterine devices and systems"],"prefix":"10.1136","volume":"40","author":[{"given":"Ellen","family":"Golightly","sequence":"first","affiliation":[{"name":"Specialist Registrar, Department of Obstetrics and Gynaecology, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ailsa E","family":"Gebbie","sequence":"additional","affiliation":[{"name":"Consultant Gynaecologist, NHS Lothian Sexual and Reproductive Health Services, Chalmers Centre, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,1,6]]},"reference":[{"key":"2025090221573026000_40.2.108.1","unstructured":"National Institute for Health and Care Excellence (NICE). Long-acting Reversible Contraception: The Effective and Appropriate Use of Long-acting Reversible Contraception. 2005. http:\/\/www.nice.org.uk\/pdf\/CG030fullguideline.pdf [accessed 2 March 2013]."},{"key":"2025090221573026000_40.2.108.2","unstructured":"Faculty of Family Planning and Reproductive Healthcare Clinical Effectiveness Unit. FFPRHC Guidance (November 2007) Intrauterine Contraception. http:\/\/www.fsrh.org\/pdfs\/CEUGuidanceIntrauterineContraceptionNov07.pdf [accessed 2 March 2013]."},{"key":"2025090221573026000_40.2.108.3","first-page":"112","article-title":"Intrauterine device failure: relation to its location within the uterine cavity","volume":"81","author":"Anteby","year":"1993","journal-title":"Obstet Gynecol"},{"key":"2025090221573026000_40.2.108.4","doi-asserted-by":"crossref","unstructured":"Golightly E Gebbie AE . Clinicians\u2019 views on low-lying intrauterine devices or systems. J Fam Plann Reprod Health Care 2014;40:113\u2013116.","DOI":"10.1136\/jfprhc-2012-100384"},{"key":"2025090221573026000_40.2.108.5","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/del208"},{"key":"2025090221573026000_40.2.108.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(01)00215-3"},{"key":"2025090221573026000_40.2.108.7","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.ajog.2010.12.058","article-title":"Intrauterine devices in early pregnancy: findings on ultrasound and clinical outcomes","volume":"204","author":"Moschos","year":"2011","journal-title":"Am J Obstet Gynecol"},{"key":"2025090221573026000_40.2.108.8","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1097\/AOG.0b013e3182316308","article-title":"Malpositioned intrauterine contraceptive devices: risk factors, outcomes, and future pregnancies","volume":"118","author":"Braaten","year":"2011","journal-title":"Obstet 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