CASE 1
Pregnancy Carried to Term After Conceiving with an Etonogestrel Subdermal Implant in Place
A 26-year-old woman, gravida 3 para 2002, with an Implanon in place for 29 months, presented with a chief complaint of cessation of menses and a positive home pregnancy test. A viable singleton intrauterine pregnancy was confirmed via transvaginal ultrasound. The crown-rump-length was measured to be 0.41 cm, which was consistent with an estimated gestational age of 6 weeks and 1 day. At this point, the Implanon was immediately removed intact. The patient had no significant medical history and was not on any additional medications throughout the duration of Implanon use. The patient’s body mass index (BMI) was 24.5 at the time of Implanon insertion. Her pregnancy course was unremarkable and all antenatal testing, including the quad screen, were normal. The anatomy ultrasound performed at 20 weeks gestation was significant for an intracardiac echogenic focus and an anterior placenta. The pregnancy resulted in a viable male infant born at 39 weeks and 6 days gestation via spontaneous vaginal delivery following elective induction of labor for social …show more content…
A serum ß-hCG collected at the patient’s initial presentation was 1283. The patient was instructed to return to the clinic for an ultrasound evaluation to allow for the ß-hCG to rise above the discrimatory zone and for Nexplanon removal upon confirmation of intrauterine pregnancy. Three days later, the serum ß-hCG was repeated and returned with a value of 1525, indicating an inappropriate rise. A transvaginal ultrasound was conducted to look for the presence of an intrauterine pregnancy and to determine dating, however the gestational sac appeared misshapen. Thus, a viable intrauterine pregnancy was unable to be confirmed. There were no masses appreciated outside of the uterine
Pregnancy Carried to Term After Conceiving with an Etonogestrel Subdermal Implant in Place
A 26-year-old woman, gravida 3 para 2002, with an Implanon in place for 29 months, presented with a chief complaint of cessation of menses and a positive home pregnancy test. A viable singleton intrauterine pregnancy was confirmed via transvaginal ultrasound. The crown-rump-length was measured to be 0.41 cm, which was consistent with an estimated gestational age of 6 weeks and 1 day. At this point, the Implanon was immediately removed intact. The patient had no significant medical history and was not on any additional medications throughout the duration of Implanon use. The patient’s body mass index (BMI) was 24.5 at the time of Implanon insertion. Her pregnancy course was unremarkable and all antenatal testing, including the quad screen, were normal. The anatomy ultrasound performed at 20 weeks gestation was significant for an intracardiac echogenic focus and an anterior placenta. The pregnancy resulted in a viable male infant born at 39 weeks and 6 days gestation via spontaneous vaginal delivery following elective induction of labor for social …show more content…
A serum ß-hCG collected at the patient’s initial presentation was 1283. The patient was instructed to return to the clinic for an ultrasound evaluation to allow for the ß-hCG to rise above the discrimatory zone and for Nexplanon removal upon confirmation of intrauterine pregnancy. Three days later, the serum ß-hCG was repeated and returned with a value of 1525, indicating an inappropriate rise. A transvaginal ultrasound was conducted to look for the presence of an intrauterine pregnancy and to determine dating, however the gestational sac appeared misshapen. Thus, a viable intrauterine pregnancy was unable to be confirmed. There were no masses appreciated outside of the uterine