Intrauterine pregnancy of uncertain viability with intrauterine device
Presentation
The patient presented to the emergency department with pelvic pain and active vaginal bleeding. Quantitative HCG was obtained and came back positive (over 8,000). The patient had an intrauterine device that was placed five years ago.
Patient Data
Transabdominal
Homogeneous uterine parenchyma and intrauterine devices are in the intrauterine canal. The intrauterine gestational sac is seen, and MSD measures 0.9 cm. The yolk sac is visualized within the gestational sac. No fetal pole or cardiac activity is identified. There is a right ovary complex cystic lesion with peripheral vascularity measuring 1.9 x 1.5 x 2.2 cm, a probable corpus luteal cyst.
Case Discussion
The patient's presentation, history, blood work results, and ultrasound report likely present an intrauterine pregnancy of uncertain viability in the presence of an intrauterine device. Recommend correlation with serial beta HCG, follow-up with OB/GYN, and pelvic ultrasound in 7–14 days.
Case co-author: Dr. Haziq Zahir, Diagnostic Radiology Department.
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