Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
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This case study reports on an obstetric rarity -- an intrauterine and an extrauterine pregnancy of a patient with an IUD in place. The 26-year-old primigravid patient had a previous history of cesarean section for cephalopelvic disproportion. 10 months after the cesarean section a Lippes Loop D was inserted. 2 months after the insertion she was hospitalized for heavy vaginal bleeding following a menstrual delay of 3 weeks. The IUD was shown to be correctly inserted. The uterine cervix was soft and half open. Upon palpation the uterus was found to be enlarged. The probable diagnosis was incomplete spontaneous abortion. IUD removal was followed by curettage. The pathologist's report confirmed the diagnosis of spontaneous abortion. A week after the curettage the patient again complained of scant vaginal bleeding and cramping pain localized in the lower abdomen. She was given ethinyl nortestosterone acetate and ethinyl estradiol for 10 days. After 48 hours of treatment the bleeding stopped. A month later the patient reported copious vaginal bleeding. Another curettage was performed in which several clots were removed. A puncture of the posterior fornix was performed with negative results. Examination of the patient under anesthesia revealed a small mass in the right lower quadrant. The 2nd pathology report on the clots referred to "endometrial tissue with signs of progesterone treatment" without an Arias-Stella image. 5 days after the last curettage the patient was admitted with abdominal pains, vaginal bleeding, weakness, and dizziness. An extrauterine pregnancy was suspected and a laparoscopy was performed. A ruptured right tubal pregnancy was found. A salpingectomy was then performed. Because of the reliability of the patient, it is certain that she did not have intercourse after the 1st curettage. This fact invalidates the possibility of an ectopic pregnancy occurring after her normal pregnancy.
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PMID:Double (uterine and ectopic) pregnancy of a patient using an intrauterine contraceptive device. 646 63