Ruptured Ectopic Pregnancy With Properly Placed Intrauterine Device: A Case Report

The intrauterine device (IUD) is a popular contraception choice for women worldwide, due to a low failure rate. Although it is highly effective, it does not eliminate the risk for an ectopic pregnancy. An ectopic pregnancy occurs when a previously fertilized ovum implants outside of the uterus that can become life-threatening. In this case study, a female patient presented to a freestanding emergency department with abdominal pain, without bleeding. A sonogram showed a normal uterus with an IUD in the correct location, normal ovaries, as well as significant fluid in the pelvis and abdomen. A pregnancy test was ordered after imaging, which came back as a positive result. The patient’s blood pressure as well as her complete blood count continued to decrease, and she underwent surgery that revealed a ruptured ectopic pregnancy in the right fallopian tube and hemoperitoneum. This case highlights the importance that a properly placed IUD, without issue, does not exclude the possibility of an ectopic pregnancy.