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Hysteroscopic treatment of early pregnancy conceived despite intrauterine contraception.


 Experience with a hysteroscope for management of pregnancy with and IUD in place in 28 cases is described. Patients had positive pregnancy tests, were 6-11 weeks pregnant, aged 21-37, and 11 were primigravidae. An operating hysteroscope with a 7 mm shaft and wide-angle objective was used with a single handed control, and carbon dioxide insufflation. 2 women had no gestational sac, and were found on laparotomy to have ectopic pregnancies. 5 women had abnormal gestations visible macroscopically, by their green, brown, clotted, folded or atonic gestational sac. 21 patients had apparently normal pregnancies, of which 3 had no IUD in situ and 18 had an IUD. The procedures took 20 minutes maximum, and were not painful for gravid women. Vaginal bleeding lasted about 3 days. Pregnancy outcomes were 13 term infants, 2 spontaneous abortions, 1 premature, and 2 still pregnant. The advantages of hysteroscopy are certain diagnosis with location of the IUD, noninvasive, painless outpatient procedure, and no damage to the fetus.
