Pregnancy with Mirena IUD: What to Do & Expect

Question
Hi!  I had a Mirena I.U.D put into place in March of 2007.  I took a pregnancy test this evening and it came up positive.  I"m going to take another one in the morning to make sure I"m not seeing double, ha ha.  I already have a 2 year old and a 1 year old so you can imagine my surprise and utter shock.  I'm just wondering what might happen.  I've read from various places that more often than not, being pregnant while having an iud either in or removed causes miscarriage.  Today is saturday so I'll have to wait until monday to contact my dr's office.  Thank you in advance for your time.

Answer
Dear Liz,

When pregnancy occurs with an IUD in place, the IUD is typically removed. This procedure can occasionally induce a miscarriage, but it can be done without any complication whatsoever too. If for some reason the Mirena IUD cannot be removed, there is an increased risk of miscarriage, sepsis, premature labor and premature delivery.

It is important to note that in large clinical trials of Mirena, half of all pregnancies detected during the studies were ectopic. An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. Almost all ectopic pregnancies occur in a fallopian tube - thus, sometimes called tubal pregnancies.

Ectopic pregnancies are diagnosed by your doctor, who will probably first perform a pelvic exam to locate pain, tenderness or a mass in the abdomen and usually will also use an ultrasound to determine whether the uterus contains a developing fetus. The hCG level is also important. An hCG level that is lower than what would be expected is one reason to suspect an ectopic pregnancy. Low levels of progesterone may also indicate that a pregnancy is abnormal.

Symptoms of an ectopic pregnancy would include:
- Vaginal bleeding, heavier or lighter than your normal period
- Gastrointestinal symptoms
- Weakness, dizziness, or fainting
- Sharp or stabbing pain that may come and go and vary in intensity. The pain may be in the pelvis, abdomen or even the shoulder and neck (due to blood from a ruptured ectopic pregnancy gathering up under the diaphragm). This should be reported to your doctor right away.

It will be important for your doctor to confirm whether the pregnancy is located within the uterus as soon as possible. I hope this has helped you and answered your question. I wish you well.

Brenda