Pregnancy with an intrauterine device in place

The patient presented with symptoms of abnormal vaginal bleeding a year after the insertion of an intrauterine device (IUD). The patient had a positive pregnancy test, and ultrasound evaluation was performed to rule out ectopic pregnancy (Figure). The risks of pregnancy with a levonorgestrel-releasing IUD (LNG-IUD; Skyla, Bayer Healthcare, Whippany, NJ) include spontaneous abortion, infection, and preterm delivery. No teratogenic effects of the IUD are reported. Identification of the IUD after delivery of the placenta is crucial to confirm the lack of uterine perforation or retention of a foreign body. Patient was counseled to avoid the use of an LNG-IUD for prevention of future pregnancy owing to the theoretical risk of recurrence.