Perforation of the cervix by threads from an intrauterine system

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4691 (Published 06 August 2014) Cite this as: BMJ 2014;349:g4691
  1. Deepti Cheema, specialist trainee year 6,
  2. Feras Izzat, consultant obstetrician, gynaecologist, and early pregnancy assessment unit lead
  1. 1University Hospitals of Coventry and Warwickshire, Coventry CV2 2DX, UK
  1. Correspondence to: D Cheema deepti.cheema{at}uhcw.nhs.uk

This picture shows the displaced threads of an intrauterine system, which have perforated the cervix and appear in the 2 o’clock position instead of the cervical os. This was discovered during a routine smear test—the patient had not reported a problem. The correct intrauterine placement of the device was confirmed by ultrasound and hysteroscopy, but the threads had perforated the endocervical canal. An incorrect attempt at pulling on the threads to remove the coil would have caused cervical trauma. The device was removed by grasping the threads from the endocervical canal during hysteroscopy. The patient had no anatomical defects in her uterus or cervix.


Cite this as: BMJ 2014;349:g4691


  • Patient consent obtained.

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