Differential Diagnosis for Cramping and Bleeding 1 Week After Liletta IUD Insertion

• Single Most Likely Diagnosis
  • Normal Side Effects of IUD Insertion: Cramping and bleeding are common side effects after IUD insertion, especially within the first week. The body is adjusting to the presence of the device, and these symptoms often resolve on their own.
• Other Likely Diagnoses
  • Infection: Bacterial infection can occur after IUD insertion, leading to symptoms like cramping, bleeding, and fever. It's essential to monitor for signs of infection and treat promptly if suspected.
  • Perforation: Although rare, the IUD can perforate the uterus during or after insertion, causing cramping, bleeding, and potentially severe complications if not addressed.
  • Expulsion: The IUD can be expelled from the uterus, especially during the first few weeks after insertion. Symptoms may include cramping, bleeding, and the sensation of the IUD being expelled.
• Do Not Miss Diagnoses
  • Ectopic Pregnancy: Although Liletta is a form of contraception, it is not 100% effective. If a pregnancy were to occur, there's a higher risk of it being ectopic with an IUD in place. Severe abdominal pain and bleeding could indicate an ectopic pregnancy, which is a medical emergency.
  • Pelvic Inflammatory Disease (PID): While less common, PID can occur after IUD insertion, especially if an infection is present at the time of insertion. PID can lead to severe consequences, including infertility and chronic pelvic pain, if not treated promptly.
• Rare Diagnoses
  • Uterine Rupture: Extremely rare, uterine rupture can occur if the IUD perforates the uterus and causes significant damage. This would be an emergency situation requiring immediate medical attention.
  • Ovarian Cyst Rupture: Although not directly related to IUD insertion, ovarian cyst rupture can cause similar symptoms of severe cramping and bleeding. It's essential to consider this in the differential diagnosis, especially if the patient has a history of ovarian cysts.