Ectopic pregnancy in a patient with levonorgestrel-releasing intrauterine device in situ

Ectopic pregnancy in a patient with levonorgestrel-releasing intrauterine device in situ

The levonorgestrel-releasing intrauterine device (LNG-IUD, Mirena) is an effective and safe contraceptive method that has many non-contraceptive benefits, such as treatment of menorrhagia and protection from pelvic inflammatory disease. However, dangerous complications, such as ectopic pregnancy, can occur with LNG-IUD use. Although the cumulative pregnancy rate with LNG-IUD is below the non-contraceptive rate, when pregnancy does occur, it is more likely to be an ectopic pregnancy. Early diagnosis and treatment are very important in order to reduce morbidity and mortality. In the case presented herein, a 35-year-old patient with an LNG-IUD in situ underwent laparoscopic salpingectomy after a diagnosis of ampullary ectopic pregnancy. 

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  • Andersson, K., Odlind, V., Rybo, G., 1994. Levonorgestrel releasing and copper releasing (Nova T) IUDs during five years of use: A random- ized comparative trial. Contraception. 49, 56-72.
  • Backman, T., Huhtala, S., Blom, T., 2000. Length of use and symptoms associated with premature removal of the levonorgestrel intrauterine system: A nation-wide study of 17.360 users. B.J.O.G. 107, 335-339.
  • Bednarek Paula, H., Jensen Jeffry, T., 2009. Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS. Int. J. Woman’s Health. 1, 45-58.
  • Beltman, J.J., Groot, C.J.M., 2009. Cornual pregnancy as a complication of the use of a levonorgestrel intrauterine device: A case report. J. Med. Case Reports. 3, 8387.
  • Cahill, P. D. J., Wardle, P. G., 2007. Bleeding and pain in early pregnancy. In high risk pregnancy management options, third edition. D. K. James, P. J. Steer, C. P. Weiner, B. Gonik, eds. Sounders Elsevier, U.S.A, 91-96.
  • Kailasam, C., Cahill, P. D. J., 2008. Review of the safety, efficacy and patient acceptability of the levonorgestrel-releasing intrauterine system. Patient Prefer Adherence. 2, 293-302.
  • Luukkainen, T., Allonen, H., Haukkamaa, M., Holma, P., Pyorala, T., Terho, J., Toivonen, J., Batar, I., Lampe, L., Andersson, K., 1987. Effec- tive contraception with the levonorgestrel-releasing intrauterine device: 12-month report of a European multicenter study. Contraception. 36, 169-179.
  • Malinowski, A., Bates, S.K., 2006. Semantics and pitfalls in the diagnosis of corneal-interstitial pregnancy. Fertil. Steril. 86, 1764.
  • Mikkelsen, M.S., Hqjgaard, A., Bor, P., 2010. Extrauterin pregnancy with gestagen-releasing intrauterine device in situ. Ugeskr Laeger. 172, 1304-1305.
  • Sivin, I., el Mahgoub, S., McCarthy, T., Mishell, D.R.Jr., Shoupe, D., Alvarez, F., Brache, V., Jimenez, E., Diaz, J., Faundes, A., 1990. Long-term contraception with the levonorgestrel 20 mcg/day (LNG 20) and the Copper T 380 Ag intrauterin devices: A five year randomized study. Contraception. 42, 361-367.
  • Turok, D.K., Gurtcheff, S.E., Gibson, K., Handley, E., Simonsen, S., Murphy, P.A., 2010. Operative management of intrauterine device com- plications: A case report series. Contraception. 82, 354-357.