Early pregnancy with an intrauterine device in place
© Springer-Verlag 2011
Received: 28 January 2011
Accepted: 15 April 2011
Published: 1 May 2011
A 22-year-old female presented with the complaint of vaginal bleeding 1 week after a positive pregnancy test. An emergency department bedside transvaginal ultrasound revealed an early intrauterine pregnancy (IUP) in the presence of an intrauterine device (IUD).
While a rare event, pregnancy can occur in the presence of an IUD. The emergency physician should be aware of the complications of this obstetrical condition.
KeywordsBedside ultrasound Pelvic ultrasound Vaginal bleeding Intrauterine device
The patient was discharged home and followed up with her OB/Gyn provider 1 week later. At that visit, the decision was made to leave the IUD in place for the remainder of the pregnancy. At the time of this report, the patient’s vaginal bleeding had stopped and her pregnancy was continuing.
It has been estimated that pregnancy occurs approximately 2% of the time with an IUD in place . According to some studies, more than of 50% of these pregnancies end in spontaneous abortion . These pregnancies are also at a much higher risk of adverse outcomes including premature rupture of membranes (PROM), placental abruption, placental previa, preterm delivery, Apgar scores <7 at 5 min, low birthweight, congenital malformation, and chorioamnionitis . Several studies have been performed to investigate if an IUD should be removed or left in place when pregnancy occurs. Recommendations favor removal of the IUD if the string is visible and the device can easily be removed through the cervix; however; this is a high-risk obstetrical decision and one best made by the patient’s OB/Gyn provider .
Conflict of interest
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