<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-5173</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Medicina Geral e Familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Med Geral Fam]]></abbrev-journal-title>
<issn>2182-5173</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Medicina Geral e Familiar]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-51732022000400392</article-id>
<article-id pub-id-type="doi">10.32385/rpmgf.v38i4.13317</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[O estranho desaparecimento do dispositivo intrauterino de cobre: relato de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[The strange disappearance of a copper intrauterine device: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonçalves]]></surname>
<given-names><![CDATA[Ana Rita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Oliveira]]></surname>
<given-names><![CDATA[Ana Catarina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domingues]]></surname>
<given-names><![CDATA[Inês Gonçalo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Carina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caetano]]></surname>
<given-names><![CDATA[José Rui]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fonte]]></surname>
<given-names><![CDATA[António Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A5"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Machado]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,ACeS Cávado I USF do Minho ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,ACeS Cávado I USF do Minho ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,ACeS Cávado I USF do Minho ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,University of Minho School of Medicine Life and Health Sciences Research Institute]]></institution>
<addr-line><![CDATA[Braga ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Government Associate Laboratory  ]]></institution>
<addr-line><![CDATA[Braga/Guimarães ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>08</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>08</month>
<year>2022</year>
</pub-date>
<volume>38</volume>
<numero>4</numero>
<fpage>392</fpage>
<lpage>395</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-51732022000400392&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-51732022000400392&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-51732022000400392&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Este caso descreve um dos efeitos adversos possíveis da contraceção intrauterina, nomeadamente do dispositivo intrauterino de cobre (Cu-DIU), e explora o procedimento a realizar no âmbito dos cuidados de saúde primários (CSP).  Descrição do caso:  Em outubro de 2019, a utente optou por Cu-DIU e realizou uma ecografia pré-procedimento (sem alterações). Em fevereiro de 2020 foi colocado um Cu-DIU nos CSP, o que ocorreu sem intercorrências; pediu-se ecografia de controlo. Devido ao contexto pandémico, a utente não a realizou e manteve método de barreira. Em março de 2021, a ecografia realizada não identificou o Cu-DIU. A utente negou perceção de expulsão do dispositivo ou outros sintomas. Na observação não foram detetados os fios do Cu-DIU, pelo que se solicitou radiografia abdominal. Realizada em abril de 2021, esta mostrava o dispositivo &#8220;na zona média da escavação pélvica, em posição oblíqua de perfil&#8221;. Uma nova ecografia ginecológica identificou o DIU na &#8220;escavação pélvica, em topografia extrauterina, lateralizado à esquerda do útero&#8221;. A utente foi encaminhada para consulta hospitalar urgente e notificou-se a ocorrência à Unidade de Vigilância de Produtos de Saúde (UVPS), da Direção de Produtos de Saúde (DPS) do INFARMED. Em consulta de ginecologia, em junho de 2021, a utente ficou inscrita para laparoscopia para remoção de Cu-DIU e salpingectomia bilateral para contraceção definitiva.  Comentário:  Este caso alerta para a importância da avaliação ecográfica, após colocação de dispositivos intrauterinos, para confirmação da sua localização e garantia, por um lado, da eficácia do método e, por outro, da rápida deteção de complicações. Pretendeu-se ainda fazer uma breve revisão do procedimento a adotar em casos semelhantes: realização de exame físico e exames complementares de diagnóstico, participação às autoridades competentes e referenciação precoce à ginecologia para a rápida resolução da situação.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  This case report describes one of the possible adverse effects of Intrauterine devices (IUD) and explores the correct procedure in the primary health care setting.  Case description:  In October 2019, the patient chose a Copper intrauterine device (Cu-IUD) and a pre-procedure ultrasound was performed (no changes detected). In February 2020, the Cu-IUD was introduced without complications and an ultrasound was required to confirm its correct positioning. Due to the COVID-19 pandemic, the patient didn&#8217;t do it and kept condom use. In March 2021, after a new request, the ultrasound performed did not identify the device. The patient denied having expelled the device or any other symptoms. At our observation, the wires were not visible. An abdominal X-ray was performed, showing the device &#8220;in the middle area of the pelvic excavation, in an oblique position&#8221;. A new ultrasound then revealed the &#8220;presence of IUD in the pelvic cup, in extrauterine topography, lateralized to the left side of the uterus&#8221;. The patient was sent to an urgent gynecology appointment and the Health Products Surveillance Unit of INFARMED was notified. In June 2021, she was enrolled for laparoscopy for Cu-IUD removal and bilateral salpingectomy for definitive contraception.  Comment:  This case highlights the importance of ultrasound evaluation after placement of intrauterine devices, confirming their location and guaranteeing the effectiveness of the method and the rapid detection of complications. It was intended to review the correct procedure: physical examination, complementary diagnostic tests, participation to the competent authorities, and early referral to gynecology for rapid resolution of the incident.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Dispositivo intrauterino de cobre]]></kwd>
<kwd lng="pt"><![CDATA[Efeitos adversos]]></kwd>
<kwd lng="pt"><![CDATA[Relato de caso]]></kwd>
<kwd lng="en"><![CDATA[Copper intrauterine device]]></kwd>
<kwd lng="en"><![CDATA[Adverse effects]]></kwd>
<kwd lng="en"><![CDATA[Case report]]></kwd>
</kwd-group>
</article-meta>
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