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Pregnancy with intrauterine contraceptive device

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

History of intrauterine contraceptive device insertion since 3 months.

Patient Data

Age: 35 years
Gender: Female

Antenatal scan

ultrasound

Normal intrauterine pregnancy is noted at the upper part of the endometrial cavity. The placenta is posterior fundal with grade I maturity. The fetal scan was unremarkable with a mean gestational age of 14 weeks.

The intrauterine contraceptive device is seen behind the left side of the amniotic sac, insinuated behind the left lateral edge of the placenta. It lies 4.7 cm from the internal os. No subchorionic collections noted.

Follow up after 1 month

ultrasound

The contraceptive device changed its position from the left posterior location to the right anterior location. No current relation to the placenta.

Contraceptive device detection is improved by the appearance of a reverberation artifact.

Case Discussion

After 2 months of intrauterine contraceptive device insertion, the patient noticed a delayed period and was tested for pregnancy which was positive. The patient chose to continue the pregnancy and the gynecologist tried to get the IUCD out, but it failed and further impaction occurred. 

The intrauterine contraceptive device can change its position during pregnancy progression with no complication.

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