Unruptured Ectopic Pregnancy at Eight Weeks in a Woman With an Intrauterine Device

Ectopic pregnancy, a rare entity, represents a significant cause of maternal morbidity and mortality in the first trimester, with the fallopian tube being the most common implantation site. While intrauterine devices (IUDs) are highly effective contraceptives that reduce overall pregnancy risk, contraceptive failure with an IUD in situ is associated with a slightly higher rate of ectopic pregnancy compared to women not using contraception. This case report describes an 8-week and 4-day unruptured tubal ectopic pregnancy in a 38-year-old multiparous woman with a well-positioned 52-mg levonorgestrel-releasing intrauterine device (L-IUD) that had been in place for one year. The patient presented with breast tenderness and a positive pregnancy test but was otherwise asymptomatic, with no pelvic pain or vaginal bleeding. She underwent successful laparoscopic bilateral salpingectomy and was discharged within 24 hours without complications. This case highlights the importance of maintaining clinical vigilance for ectopic pregnancy in women with IUDs, even in the absence of typical symptoms, and demonstrates that advanced gestational age tubal pregnancies can remain unruptured. Clinicians should consider ectopic pregnancy from the differential diagnosis in asymptomatic women with IUDs who present with a positive pregnancy test.