Carrying a Pregnancy to Term With an Intrauterine Device in Place: A Case of an Intraabdominal Intrauterine Device Migration

TL;DR

A woman carried a pregnancy to term while an intrauterine device had migrated to her abdomen, highlighting a rare complication of IUD use.

Contribution

This case report highlights an unusual instance of IUD migration and pregnancy, offering insights into rare contraceptive complications.

Findings

An IUD migrated to the abdominal cavity two years after placement.

The patient became pregnant and delivered vaginally while the IUD was in the abdomen.

The IUD was successfully identified and removed via CT and surgery.

Abstract

Long-acting intrauterine contraceptives such as intrauterine devices (IUD) are popular due to their high rates of long-term efficacy, ease of use, and reversibility. Though rare, these devices can incur complications such as uterine perforation. Signs and symptoms are often vague abdominal and pelvic pain, and patients rarely present with a surgical emergency. This uterine perforation can happen immediately upon IUD placement or in a delayed manner. This case details an example of an IUD uterine perforation with abdominal migration two years after placement. The patient's history is complicated by the unique fact that she became pregnant and carried her pregnancy to a term vaginal delivery after the IUD had been placed. Her pregnancy led healthcare providers from previous encounters to believe that the IUD had been spontaneously expelled. The IUD was identified in the patient's left lower abdominal cavity via computed tomography (CT) and was surgically removed uneventfully.

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