背景:使用宫内节育器(IUD)进行避孕的个体的总体妊娠率<1%。如果在宫内节育器就位时怀孕,异位妊娠的风险更高。我们报告了一名怀孕7周并在1周后自然流产的IUD妇女的病例。
方法:一位32岁的女性到我们的门诊部进行了几天的间歇性阴道染色。
方法:她怀孕7周,放置宫内节育器超过4年。阴道检查显示没有阴道出血和血凝块;然而,观察到一个胎下子宫颈。IUD字符串不可见。经阴道超声检查显示子宫腔有一个孕囊,胎杆和冠状臀部长度为11.4毫米。胎儿心率为159次/分钟。宫内节育器位于胎盘后区域。双侧附件正常(右卵巢,2.9厘米;左卵巢,2.5厘米)。该患者被诊断为宫内妊娠,宫内节育器就位并有先兆流产。
方法:移除宫内节育器的尝试由于其位置而被放弃,保守治疗开始于Utrogestan(100mg),每天3次,共1周.建议卧床休息。
结果:不幸的是,一周后,她经历了一次完全流产。
结论:本病例报告的新颖性在于罕见的宫内妊娠并长期放置宫内节育器,宫内节育器的具体位置带来的挑战,以及在这种情况下对先兆流产的复杂管理。我们的案例强调了宫内节育器到位的宫内妊娠的诊断管理方法。此外,探讨宫内节育器位置对妊娠预后的影响.
BACKGROUND: The overall pregnancy rate in individuals with an intrauterine device (IUD) for contraception is <1%. If pregnancy occurs while an IUD is in place, there is a higher risk of an ectopic pregnancy. We report the
case of a woman with an IUD who was 7 weeks pregnant and experienced a spontaneous abortion 1 week later.
METHODS: A 32-year-old woman presented to our outpatient department with intermittent vaginal staining for several days.
METHODS: She was 7 weeks pregnant and had an IUD in place for over 4 years. A vaginal examination revealed no vaginal bleeding and no blood clots; however, a parous cervix was observed. The IUD string was not visible. Transvaginal ultrasonography revealed a gestational sac in the uterine cavity, with a fetal pole and a crown-rump length of 11.4 mm. The fetal heart rate was 159 beats/min. The IUD was located in the retroplacental region. The bilateral adnexa appeared normal (right ovary, 2.9 cm; left ovary, 2.5 cm). The patient was diagnosed with an intrauterine pregnancy with an IUD in place and threatened abortion.
METHODS: Attempts to remove the IUD were abandoned due to its location, and conservative treatment was initiated with Utrogestan (100 mg) administered 3 times a day for 1 week. Bed rest was advised.
RESULTS: Unfortunately, she experienced a complete abortion 1 week later.
CONCLUSIONS: The novelty of this
case report lies in the rare occurrence of an intrauterine pregnancy with a long-term IUD in place, the challenges posed by the IUD\'s specific location, and the complex management of threatened abortion in this context. Our
case highlights the diagnostic management approach for intrauterine pregnancy with an IUD in place. Furthermore, it explores the impact of IUD location on pregnancy prognosis.