Background

Intrauterine devices (IUDs) are contraindicated in patients with known uterine anomalies, eliminating an extremely effective contraceptive option. However, data regarding contraceptive desires in these patients are limited to a few case reports.

Case

A 20-year-old nulligravida with a uterus didelphys desired contraception after oral contraceptive pills and an etonogestrel implant failed. Despite extensive counseling, including Centers for Disease Control and Prevention guidelines regarding contraindications for IUD placement in the setting of a uterine anomaly, she desired to proceed with placement of 2 IUDs. Two 13.5-mg levonorgestrel IUDs were successfully placed into each uterine horn.

Summary and Conclusion

In select patients with uterine anomalies, IUD placement can be a safe and effective option. This is especially important in adolescents who might be at increased risk for unintended pregnancy and poor obstetric outcomes.

中文翻译：

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在双子宫畸形患者中使用两种左炔诺孕酮宫内节育器：病例报告

背景

已知子宫异常的患者禁用宫内节育器 (IUD)，这消除了一种极其有效的避孕选择。然而，关于这些患者避孕意愿的数据仅限于少数病例报告。

案子

一名患有双子宫的 20 岁未产妇在口服避孕药和依托孕烯植入物失败后希望避孕。尽管进行了广泛的咨询，包括疾病控制和预防中心关于在子宫异常情况下放置宫内节育器的禁忌症的指南，她还是希望继续放置 2 个宫内节育器。两个 13.5 毫克左炔诺孕酮宫内节育器被成功放入每个子宫角。

总结与结论

对于特定的子宫异常患者，放置宫内节育器可能是一种安全有效的选择。这对于意外怀孕和不良产科结局风险可能增加的青少年尤为重要。