A rare case of ovarian ectopic pregnancy with IUD in situ
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A 33 year old lady with G4P3L3 had presented to the Emergency Department (ED) with a history of amenorrhea for 43 days and irregular vaginal bleeding for the past 2 weeks with the partial soaking of one pad per day. She also had abdominal pain and occasional dizziness on the day she visited the ED. She also gave a history of having regular menstruation cycles in the past. Her last childbirth was 9 years back. She had been using Copper T (Cu T 380A) as a form of contraception for the last 5 years. She gave no history of use of any form of contraception prior to that.

She was well oriented to time, place, and person but looked pale. Her blood pressure was 110 mm Hg systolic and 60 mm Hg diastolic, and her pulse was 108 beats per min. On abdominal examination, there was generalized tenderness over the suprapubic region with mild distension. The vulva and vagina looked healthy. Copper T thread was visible on the speculum examination, and the cervix looked healthy. Her pelvic examination was significant for a firm mobile mass around the right adnexa of 4 × 4 cm. Despite the history of contraception, the examination findings led to a strong suspicion toward the differential diagnosis of ectopic pregnancy.

The author decided to perform exploratory laparotomy on the patient after taking proper informed consent for the removal of IUD and the operative procedure.

Hemoperitoneum of 1 L was appreciated. The right ovary was 4 × 5 cm in size with a defect of one cm on its surface, a firm mass inside, and clots overlying it. Bilateral fallopian tubes and left sided ovary were normal. They performed right sided oophorectomy. The IUD string was pulled, and the device was removed in the operation theater. Gross examination of the cross-section of the ovary showed products of conception within the ovarian tissue thus confirming ovarian ectopic pregnancy. Her postoperative period was uneventful, and she was pleased with overall management at this center.

Source: https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.3393?af=R