title: Pregnancy after Essure placement: report of two cases.
abstract: OBJECTIVE
  To report two cases of pregnancy after placement of Essure micro-inserts.
  
  
  METHODS
  Case report.
  
  
  METHODS
  University-based Department of Obstetrics and Gynecology.
  
  
  METHODS
  Patient 1, a 38-year-old woman, presented with a positive pregnancy test 7 months after Essure hysteroscopic sterilization. Patient 2, a 35-year-old female, became pregnant approximately 1 year after undergoing the Essure procedure.
  
  
  METHODS
  Patient 1 received obstetric ultrasounds, a prophylactic cerclage, a cesarean section, and a tubal ligation. Patient 2 underwent a postprocedure hysterosalpingogram, an obstetric ultrasound, pregnancy termination, diagnostic pelvic ultrasound, and a hysterectomy.
  
  
  METHODS
  Documentation of normal progress of pregnancy after Essure placement.
  
  
  RESULTS
  Patient 1 carried an uncomplicated pregnancy to term with an Essure micro-insert in place. Patient 2 became pregnant despite an hysterosalpingogram showing tubal occlusion and was ultimately found to have a micro-insert perforating the uterine wall.
  
  
  CONCLUSIONS
  The presence of Essure micro-inserts in the fallopian tubes do not appear to interfere with implantation and pregnancy. Uterine perforation by an Essure micro-insert in proximity to the tubal ostia may mimic proper micro-insert placement and bilateral tubal occlusion on both hysterosalpingogram and saline infusion sonography.
authors.affiliation: Department of Obstetrics and Gynecology, University of South Carolina School of Medicine, Columbia, South Carolina, USA.
authors.forename: A Whitney
authors.initials: AW
authors.lastname: Moses
authors.forename: Judith T
authors.initials: JT
authors.lastname: Burgis
authors.forename: Janice L
authors.initials: JL
authors.lastname: Bacon
authors.forename: Jennifer
authors.initials: J
authors.lastname: Risinger
mesh_terms: D000028:Abortion, Induced; D000328:Adult; D006063:Chorionic Gonadotropin / Q000652:urine; D004867:Equipment Design; D005260:Female; D006801:Humans; D007044:Hysterectomy; D015907:Hysteroscopy; D007434:Intrauterine Devices; D050498:Live Birth; D011247:Pregnancy; D012086:Reoperation; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D017211:Treatment Failure; D014595:Uterine Perforation / Q000209:etiology
chemical_list: D006063:Chorionic Gonadotropin