CASE REPORT
A 22-year female, from London, United Kingdom, had been using the
intrauterine contraceptive device (IUCD) i.e. Copper T-380 A for 42
months. She was on her vacation to Kathmandu when she developed
increasing intermittent episodes of lower abdominal pain for 3 weeks and
hence presented to Gynecology and obstetrics out-patient-department
(OPD) with additional complaints of cessation of menstruation for 2
months. She recalled that her menstrual periods otherwise were regular
and elaborates that the lower abdominal pain was gradually progressing,
cramping intermittently in nature, non-radiating with no known
aggravating or relieving factors but was associated with episodes of
nausea.
She had her urine pregnancy test (UPT) done at home using the pregnancy
test kit 1 day before the OPD presentation which was positive. She
recalls no history of fever, vomiting, Per Vaginal (PV) spotting or
bleeding, or foul-smelling discharges in the past 2 months. The patient
had no significant co-morbidities and no relevant medical, surgical,
allergy, or psychosocial history. Her vitals were within normal limits
and systemic examination of CardioPulmonary, Central nervous system,
GastroIntestinal and GenitoUrinary systems were also within normal
limits.
An urgent transabdominal ultrasound of the abdomen and pelvis was
planned which revealed a gravid uterus containing a single gestational
sac corresponding to 7 weeks and 0 days of gestation. The yolk sac was
visualized but the fetal pole was not yet visualized. IUCD was seen in
the endometrial cavity and the long arm of the IUD was positioned
superiorly in the uterine cavity (Figure 1).