Rebecca Durante: Correct IUD Assessment Requires Evaluation of Both the Stem and Transverse Arms
Rebecca Durante, Midwife Trainee Sonographer at Chelsea and Westminster Hospital NHS, shared a post on LinkedIn:
“Think the IUD Is Normal?
Look Again with 3D Ultrasound
Correct IUD assessment requires evaluation of both the stem and transverse arms. While 2D ultrasound may suggest a normally positioned device, 3D coronal imaging can reveal subtle malposition.
In This Case
A 21-year-old nulliparous woman presented with persistent left lower quadrant pain since after IUD insertion (2 months ago).
2D Transvaginal Ultrasound
- IUD appears centrally located within the endometrial cavity.
3D Coronal View
- Misaligned IUD arms.
- Right arm extends 3 mm into the myometrium.
- Left arm extends into the uterine cornu.
These findings indicate a malpositioned IUD that is not apparent on 2D imaging.
Teaching Point: The 3D coronal view is the gold standard for assessing IUD arm position and detecting subtle embedment or malposition that may explain pelvic pain.”

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