{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:41:43Z","timestamp":1780076503383,"version":"3.54.0"},"reference-count":19,"publisher":"California Digital Library (CDL)","issue":"1","license":[{"start":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T00:00:00Z","timestamp":1548115200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Ruptured ectopic pregnancy is the leading cause of first trimester maternal mortality. The diagnosis of ectopic pregnancy should always be suspected in patients with abdominal pain, vaginal bleeding or syncope. While the use of an intrauterine device (IUD) markedly reduces the incidence of intrauterine pregnancy, it does not confer equal protection from the risk of ectopic pregnancy. In this report we discuss the case of a female patient who presented with a ruptured ectopic pregnancy and hemoperitoneum despite a correctly positioned IUD.<\/jats:p>","DOI":"10.5811\/cpcem.2019.1.41345","type":"journal-article","created":{"date-parts":[[2019,2,25]],"date-time":"2019-02-25T20:22:07Z","timestamp":1551126127000},"page":"51-54","source":"Crossref","is-referenced-by-count":10,"title":["Ruptured Ectopic Pregnancy in the Presence of an Intrauterine Device"],"prefix":"10.5811","volume":"3","author":[{"given":"Matthew","family":"Neth","sequence":"first","affiliation":[{"name":"University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxwell","family":"Thompson","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Gibson","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gullett","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Pigott","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29705","published-online":{"date-parts":[[2019,1,22]]},"reference":[{"key":"ref0","unstructured":"United Nations, Department of Economic and Social Affairs, Population Division. 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MMWR Morb Mortal Wkly Rep. 1995;44(3):46-8."},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Murray H, Baakdah H, Bardell T, et al. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005;173(8):905-12.","DOI":"10.1503\/cmaj.050222"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Sivin I and Batar I. State-of-the-art of non-hormonal methods of contraception: III. Intrauterine devices. Eur\u00a0J Contracept\u00a0Reprod\u00a0Health\u00a0Care. 2010;15(2):96-112.","DOI":"10.3109\/13625180903519885"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Callahan R, Yacobson I, Halpern V, et al. Ectopic pregnancy with use of progestin-only injectables and contraceptive implants: a systematic review. Contraception. 2015;92(6):514-22.","DOI":"10.1016\/j.contraception.2015.08.016"},{"key":"ref7","unstructured":"Hatcher RA, Nelson AL, Trussell J, et al. (2018). Contraceptive Technology (pp. 884). (21st ed.). 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IUD use and the risk of ectopic pregnancy: a meta-analysis of case-control studies. Contraception. 1995;52(1):23-34.","DOI":"10.1016\/0010-7824(95)00120-y"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Barnhart KT. Clinical practice. Ectopic pregnancy. New Engl J Med. 2009;361(4):379-87.","DOI":"10.1056\/NEJMcp0810384"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Farquhar CM. Ectopic pregnancy. Lancet. 2005;366(9485):583-91.","DOI":"10.1016\/S0140-6736(05)67103-6"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Bouyer J, Coste J, Shojaei T, et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France. Am J Epidemiol. 2003;157(3):185-94.","DOI":"10.1093\/aje\/kwf190"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Kirk E. Ultrasound in the diagnosis of ectopic pregnancy. Clin Obstet Gynecol. 2012;55(2):395-401.","DOI":"10.1097\/GRF.0b013e31824e35fe"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Winder S, Reid S, Condous G. Ultrasound diagnosis of ectopic pregnancy. Australas J Ultrasound Med. 2011;14(2):29-33.","DOI":"10.1002\/j.2205-0140.2011.tb00192.x"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Richardson A, Gallos I, Dobson S, et al. Accuracy of first-trimester ultrasound in diagnosis of tubal ectopic pregnancy in the absence of an obvious extrauterine embryo: systematic review and meta-analysis. Ultrasound Obstet Gynecol. 2016;47(1):28-37.","DOI":"10.1002\/uog.14844"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Moore C, Todd WM, O\u2019Brien E, et al. Free fluid in Morison\u2019s pouch on bedside ultrasound predicts need for operative intervention in suspected ectopic pregnancy. 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