Contraception: missing IUCD threads: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Contraception: missing IUCD threads

Sample item

A woman with a copper IUCD inserted 2 years ago cannot feel the threads and they are not visible at the os. What is the first step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Exclude pregnancy and perform an ultrasound to locate the device

Missing threads suggest retraction into the canal, expulsion, perforation or pregnancy. Pregnancy is excluded first, and pelvic ultrasound locates the device. If it is not seen in the uterus, an abdominal X-ray identifies an extrauterine or expelled device, and the woman should use other contraception meanwhile.

Option by option

  • A. Exclude pregnancy and perform an ultrasound to locate the device (correct)

    Correct. Rule out pregnancy and locate the device with ultrasound.

  • B. Immediate hysterectomy

    Hysterectomy is not indicated.

  • C. Insert a second device

    A second device in the presence of a displaced one is unsafe.

  • D. Blind curettage

    Blind curettage risks injury and does not locate the device.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, Exclude pregnancy and perform an ultrasound to locate the device. Missing threads suggest retraction into the canal, expulsion, perforation or pregnancy.

Why is "Immediate hysterectomy" not the answer?

Hysterectomy is not indicated.

Why is "Insert a second device" not the answer?

A second device in the presence of a displaced one is unsafe.

Why is "Blind curettage" not the answer?

Blind curettage risks injury and does not locate the device.

What concept does this question test?

It tests Contraception: missing IUCD threads in OBG. Pregnancy is excluded first, and pelvic ultrasound locates the device. If it is not seen in the uterus, an abdominal X-ray identifies an extrauterine or expelled device, and the woman should use other contraception meanwhile.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Contraception: missing IUCD threads?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.