Abstract:

We reported a case of the pregnancy with intrauterine devices (IUD) and uterine perforation. A 28-year-old female had a history of two full-term natural deliveries in 2018 and 2022, respectively and an IUD for one year. Due to 50 days of amenorrhea and 7 days of the displaced and incarcerated IUD, she came to our hospital for treatment. Preoperative examination, combined with serum human chorionic gonadotropin (hCG) and transvaginal ultrasound, confirmed the diagnosis of the pregnancy with IUD and uterine perforation. The IUD was completely removed, and bilateral tubal ligation was performed, under the combined hysteroscopy and laparoscopy while the negative pressure aspiration induced abortion was smoothly performed under hysteroscopy. The patient was discharged 2 days after the operation. After two weeks of postoperative follow-up, hCG was decreased to the normal range. It is suggested that the diagnosis of the pregnancy with IUD complicated by uterine perforation need a comprehensive consideration of multiple factors such as the first implantation of the IUD, improper placement of the IUD, recent pregnancy and metal IUD. Taking appropriate treatment is crucial for the prognosis of the patient.

Key words: Pregnancy, Intrauterine devices, Uterine perforation, Diagnosis, Therapy, Prognosis