Unanticipated discovery of an IUD implanted within the uterine bladder wall of a female patient, who had a missed abortion.
A 28-year-old woman with a history of five pregnancies and a copper IUD insertion a year ago, experienced a rare complication where the intrauterine device (IUD) embedded in her urinary bladder. The woman presented to the hospital due to a case of incomplete abortion at 11 weeks of gestation, reporting mild vaginal bleeding but no typical urinary symptoms.
Upon initial examination, a bimanual vaginal examination revealed mild vaginal bleeding. The patient's current pregnancy had been uneventful until the onset of symptoms. Comprehensive laboratory tests were ordered, including serial complete blood counts (CBC) every 6 hours, along with a serial collection of pads for bleeding assessment.
The patient was admitted to the hospital and intravenous access was established, with intravenous fluids initiated at a rate of 3 liters per 24 hours. Initial diagnosis was a case of missed abortion, and the patient was started on cytotoxic medication. However, ultrasonography showed retained products of conception, and an abdominal and pelvic CT scan revealed the copper IUD displaced outside the uterus, lodged in the urinary bladder wall.
Approximately 2% of migrated IUDs may involve the urinary bladder. Early detection through imaging and prompt removal of the device are essential to prevent further complications. IUD migration, even without typical urinary symptoms, should be considered in patients with unexplained pelvic issues.
The patient was referred to a specialist for further management of her pregnancy complications. After managing her condition, plans were made for surgical removal of the IUD. Regular follow-up and patient education are important for timely identification of potential issues before they escalate.
This case serves as a reminder of the importance of thorough patient history and careful monitoring during pregnancy, especially in cases involving IUD use. It is crucial for healthcare providers to be aware of the rare but possible complications associated with IUD migration.
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