Older women experience ectopic pregnancy

A 42-year-old woman went to the hospital for 10 days due to irregular vaginal bleeding. She had no history of menopause, and her vaginal bleeding time was less, but it was less than the normal menstrual volume, and she had no obvious abdominal pain. Seeing the doctor's face, he complained that he had been uncomfortable after wearing the intrauterine device, and asked to clean the palace and have surgery. The doctor wanted her to test her blood HCG once, but the patient refused, firmly believing in the old man's statement that "uterine vaginal bleeding is not clear". Seeing that he was old, the doctor didn't think much about it, so he ordered a B-ultrasound examination. The B-ultrasound indicated that the intrauterine device moved downward. Infusion anti-inflammatory symptomatic treatment was given, and the ring was removed after the vaginal bleeding stopped. After 3 days, the patient's vaginal bleeding did not stop, and the lower abdomen was swollen and uncomfortable, and surgery was required to remove the ring. After routine disinfection, a gynecological examination showed a small amount of dark red blood in the vagina, the tail of the intrauterine device ring was seen at the cervical ostium, the cervical pain was positive, and the posterior vaginal fornix was slightly painful, which highly indicated the possibility of ectopic pregnancy. An emergency blood test for HCG showed a positive result, and the diagnosis was ectopic pregnancy. The patient was transferred to surgical treatment, and the postoperative pathology indicated: tubal pregnancy abortion.

Ectopic pregnancy refers to the implantation and development of the fertilized egg outside the uterine cavity. The intrauterine contraceptive device fails, and the chance of ectopic pregnancy is greater. In this case, the patient mistakenly believes that the IUD will not cause pregnancy, firmly believes that vaginal bleeding is related to the IUD, and needs to remove the uterus and undergo surgery, which misleads the doctor's diagnosis direction. At the same time, the doctor makes a blind diagnosis without obtaining complete and detailed medical history data, which almost leads to disaster.