Older women experience ectopic pregnancy

Yue Yue, female, 42 years old, went to the hospital for irregular vaginal bleeding for 10 days. She had no history of amenorrhea. The amount of vaginal bleeding was sometimes more and sometimes less, but it was always less than the normal menstrual amount, and she had no obvious abdominal pain. When she saw the doctor, she complained that she had been feeling uncomfortable after wearing the intrauterine contraceptive device, and requested a uterine cleaning and surgery to remove the ring. The doctor wanted her to test her blood HCG, but the patient refused, firmly believing in the saying of her elders that "vaginal bleeding will not be clean without uterine cleaning." Seeing that she was older, the doctor did not think much about it and immediately ordered a B-ultrasound examination. The B-ultrasound indicated that the intrauterine contraceptive device had moved downward. Intravenous anti-inflammatory symptomatic treatment was given, and the ring was removed after the vaginal bleeding stopped. Three days later, the patient's vaginal bleeding did not stop, and she felt distended and uncomfortable in the lower abdomen, so she requested surgery to remove the ring. After routine disinfection, a gynecological examination revealed a small amount of dark red blood in the vagina, the tail of the intrauterine contraceptive device ring was seen at the cervical ostium, and the cervix was painful when raised.

Ectopic pregnancy refers to the implantation and development of a fertilized egg outside the uterine cavity. The chance of an ectopic pregnancy is high if the intrauterine device fails to prevent pregnancy. In this case, the patient mistakenly believed that she would not get pregnant if she had an IUD inserted, and firmly believed that vaginal bleeding was related to the IUD. She requested a uterine curettage and surgery to remove the IUD, which misled the doctor's diagnosis. At the same time, the doctor made a blind diagnosis without obtaining a complete and detailed medical history, which almost caused a disaster.