Ectopic pregnancy after levonorgestrel emergency contraception☆
Abstract
Background
Although the possibility of ectopic pregnancy after intake of levonorgestrel (LNG) as an emergency contraceptive (EE) pill is well-known, the causality has not been well established.
Case
A 27-year-old nulliparous woman with regular menstrual periods took 1.5-mg LNG EE midcyclic 5 h after an unprotected intercourse. She had prolonged vaginal bleeding at the expected time. She consulted the general practitioner because of continuous vaginal bleeding for 4 weeks and lower abdominal pain. The pregnancy test was positive, and her symptoms and clinical findings suggested an ectopic pregnancy. At emergency surgery, she was found to have a left tubal pregnancy.
Conclusion
The possible role of 1.5-mg LNG EE in causing ectopic pregnancy is discussed. A high serum LNG concentration decreases ciliary activity and tube motility, but further epidemiological studies are necessary to establish the risk of ectopic pregnancy following intake of LNG EE.
Keywords: Emergency contraception, Ectopic pregnancy, Levonorgestrel
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☆ None of the authors has a political, personal, intellectual, commercial, financial, religious interest, and/or other relationship with manufacturers of pharmaceuticals, laboratory supplies, and/or medical devices or with commercial providers of medically related services.
PII: S0010-7824(10)00471-3
doi:10.1016/j.contraception.2010.08.008
© 2011 Elsevier Inc. All rights reserved.
