Pregnancy with an Intrauterine Device (IUD) in Place

For some women, using an intrauterine device (IUD) to prevent undesired pregnancies is an ideal form of birth control. An intrauterine device can be ideal for many reasons. The protection provided by an intrauterine device is not only effective with a success rate of 99.9%, but it is also long term, lasting up to five years. An intrauterine device doesn’t have to be remembered every day, like pills do, and lastly, an intrauterine device can be removed at any time. Although intrauterine devices may be effective and convenient, a woman who finds herself pregnant while her intrauterine device is in place is presented with very unique issues.

Higher rate of ectopic pregnancy
Due to the nature of an intrauterine device, should a pregnancy occur, it is much more likely to be an ectopic pregnancy. An ectopic pregnancy is a pregnancy that occurs within the fallopian tubes, rather than within the uterus. An ectopic pregnancy can be life-threatening and could have a permanent impact on a woman’s fertility. Women who find themselves pregnant with an intrauterine device in place should pay very close attention for any signs of an ectopic pregnancy, which include fever, vaginal bleeding, abdominal pain and discomfort, cramps, nausea and dizziness. An ectopic pregnancy can be confirmed through an ultrasound and requires immediate surgical intervention.

Higher rate of miscarriage
Women who find themselves pregnant while a intrauterine device is in place are more likely to suffer a miscarriage than women who conceived without an intrauterine device in place. Unfortunately, the spontaneous miscarriage rate among women who concieved with an intrauterine device in place is approximately 40-50%, nearly twice as high as the miscarriage rate among women without an intrauterine device in place.

Removing the device
Women who find themselves pregnant while an intrauterine device is in place are often faced with the decision of whether or not to remove the device. For a large portion of women, removing the device for the sake of continuing the pregnancy is possible and realistic. Removal of the device, however, can present a risk to the health of the pregnancy. An example of a case where removal of the intrauterine device would be considered dangerous would be in a patient whose intrauterine device has embedded into the uterus or the baby’s placenta. In cases such as these, the pregnancy may be continued, however there is a higher risk of complications later in the pregnancy, such as preterm labor and premature birth.

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