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Pregnancy with intrauterine device — DRCOG MCQ

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ModerateEarly PregnancyPregnancy with intrauterine deviceDRCOG

A 29-year-old woman with a copper IUD has a positive pregnancy test and mild left iliac fossa pain. The IUD threads are visible. She is stable and has no bleeding. What is the most appropriate investigation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Arrange urgent early pregnancy assessment to exclude ectopic pregnancy

Pregnancy with an IUD in situ has a higher proportion of ectopic pregnancies, so urgent early pregnancy assessment is needed, especially with pain. IUD removal may be considered if intrauterine pregnancy is confirmed and threads are visible, but ectopic pregnancy must be excluded. Emergency contraception is not relevant after established pregnancy. Waiting until the dating scan could miss ectopic pregnancy.

Reference: FSRH Intrauterine Contraception; NICE NG126