Pregnancy in a Patient with an Intra-Abdominal Levonorgestrel-Releasing Intrauterine System

Background: The levonorgestrel-releasing-intrauterine system (LNG-IUS) is a frequently used method of contraception worldwide. A rare, but bothersome complication of the LNG-IUS is a perforation of the uterus after insertion. Knowledge about the preferred management option in case of an intra-abdominally situated LNG-IUS during pregnancy is lacking.

Case: This case report concerns a 33-year-old patient who became pregnant despite having an intra-abdominally situated LNG-IUS. The patient was counseled about the management options. The advantages and disadvantages of expectant management versus laparoscopic removal of the LNG-IUS were discussed, and the patient preferred removal of the IUS. The procedure was performed laparoscopically at 15 weeks of pregnancy.

Results: The IUS was removed without complications, and the patient's pregnancy proceeded uneventfully.

Conclusions: Considering the degree of evidence, it is important to make a tailor-made decision in case of a pregnancy with a perforated LNG-IUS.