Figure 8.

3-D ultrasonography: Abnormally located ParaGard intrauterine device (IUD) causing bleeding and pain (left) and middle (Mirena). Even if the IUD is apparently located in the correct position, the too-long transverse arm can cause painful contractions (right).

Note: The fundal transverse dimension in these cases (middle and right) is only approximately 2 cm. Adapted from Ultrasound in Obstetrics and Gynaecology, Volume 34, Benacerraf BR, Shipp TD, Bromly B, Three-dimensional ultrasound detection of abnormally located intrauterine contraceptive devices which are the source of pelvic pain and abnormal bleeding, pages 110–115. Copyright © 2009.⁴⁹