Diagnosis of Intrauterine Pregnancy Despite the Presence of Etonogestrel Implant

While contraception is an important method to avoid pregnancy, it is not always effective. Our case details a 33-year-old-female with an etonogestrel implant who presented to the emergency department (ED) with a two-week history of vomiting and abdominal pain. Pelvic and transvaginal ultrasound confirmed a single, live intrauterine pregnancy. Our case serves as a reminder that ED providers should have a high index of suspicion for pregnancy in clinically relevant scenarios, despite contraceptive methods, until the appropriate confirmatory diagnostic evaluation for pregnancy is completed.