Term pregnancy with intraperitoneal levonorgestrel intrauterine system: a case report and review of the literature

Background: The risk of adverse effects of fetal exposure to the levonorgestrel intrauterine system (LNG-IUS) has not been established. Study Design: In this case report and literature review, we describe a pregnant patient with an intraperitoneal LNG-IUS and the subsequent maternal and neonatal outcomes. A systematic literature search was performed to identify similar clinical reports. The MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CENTRAL, Web of Science and Scopus databases were searched from inception through March 2007. Results: The pregnancy progressed uneventfully and culminated in the elective cesarean delivery of a full-term healthy boy. Of the 35 pregnancies identified in the literature review (34 pregnancies with intrauterine LNG-IUS and 1 term delivery with intraperitoneal LNG-IUS), congenital anomalies were reported in 2 infants (6%). Conclusions: Fetal exposure to LNG-IUS is associated with a low frequency of congenital anomalies.