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Write-up: Information has been received from a Certified Medical Assistant through Merck Pregnancy concerning a 23 year old female patient with moderate dysplasia of the cervix and a history of loop electrosurgical excision procedure (LEEP) who on 02-JAN-2007 was vaccinated IM in right deltoid with a first dose of Gardasil and had menstruation cycle on that day. On 27-FEB-2007 the patient was vaccinated IM in right deltoid with a second dose of Gardasil. Concomitant therapy included Mirena IUD birth control. On 05-MAR-2007 the patient presented to office experiencing nausea. Urine pregnancy test was performed and it was positive for pregnancy. The reporter stated that client had unusual history; her birth control was a Mirena IUD but on manual examination it was not found. The MA stated that it must have expulsed. She had a cervical smear (PAP) test done which showed moderate dysplasia. On 04-NOV-2006 patient had Leep procedure performed. The patient''s outcome was unknown. Additional information has been requested.
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