Case Report: Pregnancy While Using an IUD
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A 28-year-old GII/PI woman who was admitted due to pregnancy with LNG-IUS 52 mg in the 9th gestational weeks. Sonography showed an intact pregnancy corresponding to the gestational week. The IUS was located in the lower part of the cavity at a considerable distance from the amniotic cavity.
The patient wanted to remain pregnant, so the following options were discussed: 1. Removal of the IUS under hysteroscopic control. 2. Pregnancy with IUS. She was informed that a pregnancy with an IUS is associated with preterm deliveries and an increased risk of infection. After receiving comprehensive information of both options, the patient decided to remove the IUS in the 10th gestational week (9 + 3 weeks). The procedure was performed in spinal anaesthesia.

After grasping the cervix with two tenaculums, a hysteroscopy was performed under sonographic control. Pregnancy was displayed under low pressure with saline solution. Beside it, in the lower part of the cavity, the IUS was separate and could be easily identified with threads. The IUS was carefully extracted with a grasping forceps. Subsequently, a sonographic control was carried out which showed unaffected amniotic cavity and positive heart activity. The patient remained hospitalized for one night. She did not have postoperative relevant bleeding. Four hours postoperatively and on the following day, a sonographic check was carried out, which continued to show an intact pregnancy. The patient was discharged with the recommendation of further pregnancy checks according to the maternity guidelines. Further controls were carried out in an outpatient practice and were inconspicuous. The patient gave birth spontaneously in 37 + 1 weeks after an unremarkable course of pregnancy. The healthy child weighed 2900 grams.