UNINTENDED AND ECTOPIC PREGNANCY IN WOMAN WITH IUD TRANSLOCATION WITH HISTORY OF TWO TIMES PREVIOUS CAESAREAN SECTION AND HISTORY OF SPONTANEOUS ABORTION: CASE REPORT

Problem statement: Intrauterine device (IUD) is a widely used contraceptive method. However, it may translocate to other sites within the pelvic cavity, including the intestines and the bladder. It is also associated with contraceptive failure rates between 1-3 out of 100 women/year. It also slightly increases the risk of ectopic pregnancy upon its failure. The combination of IUD translocation and contraceptive failure is rare. We present such a case.

Method: Case report

Results: A 29 years old woman gravida 4 para 2, presented with a chief complaint of abdominal pain and blood spotting for the past 7 hours . Her pregnancy test was positive. At presentation, her vital signs were still stable and she was also grade II obese with BMI 38.8 kg/m2. There was notable tenderness on abdominal examination and cervical motion tenderness too. Her blood counts were unremarkable. Transvaginal ultrasound confirmed the presence of a hypoechoic complex structure at the left adnexa, measuring 53 mm along with free fluid in the Morrison`s pouch. Emergency laparotomy was instituted. Found normal uterus with ruptured left fallopian tube with about 800 cc blood intraabdominal.

Conclusion: Despite its high efficacy, intrauterine devices may cause contraceptive failures. They also translocate to other organs. A combination of both increases the risks for an ectopic pregnancy.

Keywords: History of caesarean section and abortion; IUD translocation; unintended pregnancy; Ectopic pregnancy