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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 3064
Experience:  30 yrs experience, awarding winning educator
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I am on the coil and I've been having really strong abdominal

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I am on the coil and I've been having really strong abdominal pains to the point that I feel like I'm in labour and want to push.
Hi, It's Dr. C. Board certified Ob-Gyne with extensive experience in IUD placement and management. It would be helpful to know what type of coil, when it was placed and whether there are any other symptoms?
Customer: replied 2 years ago.
I had the mirena coil fitted In April 2014, my tummy looks bloated, I keep needing the loo. My breasts have got bigger and my nipples seem sensitive.
In that case, first you want to do a home urine pregnancy test just to be 100% sure that's not the cause. Although IUDs are VERY effective, there can be failures and thus pregnancies. If the test is negative, it's likely that you're having side effects and complications from the IUD. As long as there is no fever, heavy bleeding or severe pain, you could call the doctor tomorrow for an appointment to be seen in 1-2 days. But if fever, heavy bleeding or severe pain, an urgenet visit to the ER would be indicated. Anything else?
Did you run a pregnancy test? Any follow-up questions?

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Customer: replied 2 years ago.

Yes I did do a pregnancy test and I think I am pregnant. I also think I've pushed my coil out as I can't find the strings.

So the test showed positive? As long as it was read at the time given on the package (usually 3 minutes) and the line was present at that time, the result is 100% accurate. Yes it's possible the IUD fell out. But MUCH more often, the strings wiggle up inside the cervix and can't be felt. If the test is positive, it's VERY important that you seek care on Monday. This is a urgent situation. If there is severe pain, seek care today. The risk of ectopic pregnancy is higher when a woman gets pregnant with an IUD in place. Please reply if I can clarify anything else.
Any further questions? This must be a scary situation.
Customer: replied 2 years ago.

It is a scary situation, what is the likelihood that I could have a ectopic pregnancy?

As long as you get care quickly, chances are very high you will be perfectly fine even though the situation is scary. The risk that a pregnancy with an IUD in place is ectopic is about 50% according to studies. But in my experience, it seems lower. But if the IUD fell out, the chance will be MUCH lower, about 1%.

If you're in pain, it may be best to seek care today just to have some more information. If you went to the ER, they would confirm the pregnancy test as positive, then do an ultrasound. What they would do next would depend on your exam, the pregnancy tests beta-HCG number and the ultrasound result.

They could just release you to follow-up with a gynecologist, decide to do medical treatment, pull the IUD is it's present....

It really depends on what the work-up results are.

So if the pain is bad, head to the ER today. If not so bad, no fever, no heavy bleeding, call tomorrow. But you'll need to see a gynecologist. In the UK, that may require a referral. You need to be seen very soon., no greater than 2 days for sure but ideally today or tomorrow.

Anything else?