Heterotopic pregnancy: a case series
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20220193Keywords:
Heterotopic pregnancy, Ultrasonography, Tocolysis, SurgeryAbstract
Heterotopic pregnancy once considered a rare phenomenon is now thought to be more common as the overall incidence of ectopic pregnancy continues to increase. We report a series of six cases of heterotopic pregnancies seen in our department over a period of seven years. Two of these occurred after assisted reproductive techniques; while the other cases were spontaneous heterotopic pregnancies. The clinical presentation of these cases was varied with late diagnosis occurring in two cases. Preservation of the intrauterine pregnancy was obtained in four cases. Unfortunately, the other cases were aborted spontaneously on the postoperative period. Only with an early diagnosis and adequate management the intrauterine pregnancies will reach viability, with a great chance of a favorable obstetric outcome.
References
Reece EA, Petrie RH, Sirmans MF, Finster M, Todd WD. Combined intrauterine and extrauterine gestations: a review. Am J Obstet Gynecol. 1983;146:323-30.
Maruotti GM, Sarno L, Morlando M, Sirico A, Martinelli P, Russo T. Heterotopic pregnancy: it is really a rare event? The importance to exclude it not only after in vitro fertil¬ization but also in case of spontaneous conception. Fertil Steril. 2010;94:e49.
Alptekin H, Dal Y. Heterotopic pregnancy following IVF-ET: successful treatment with salpingostomy under spinal anesthesia and continuation of intrauterine twin pregnancy. Arch Gynecol Obstet. 2014;289:911-14.
Barrenetxea G, Barinaga-Rementeria L, Lopez DE, Agirregoikoa JA, Mandiola M, Carbonero K. Heterotopic pregnancy: two cases and a comparative review. Fertil Steril. 2007;87(417):e9-15.
Kitade M, Takeuchi H, Kikuchi I, Shimanuki H, Kumakiri J, Kinoshita K. A case of simultaneous tubal-spenic pregnancy after assisted reproductive technology. Fertil Steril. 2005;83(4):1042.
Kouach J, Moukit M, Ait El Fadel F, El Fazazi H, Guelzim K, El Hassani ME, et al. Heterotopic Pregnancy following Ovulation Induction: A Case Report. Austin Gynecol Case Rep. 2017;2(1):1011.
Jaouad K, Mounir M, Rachid A, El Mehdi EM, Abdellah B, Driss MR, et al. Heterotopic pregnancy: A report of three cases and a brief comparative review. Saudi J Health Sci. 2017;6:126-9.
Tandon R, Goel P, Saha PK, Devi L. Spontaneous heterotopic pregnancy with tubal rupture: a case report and review of the literature. J Med Case Reports. 2009;3:8153.
Mehrabian F, Robati BK. Heterotopic abdominal pregnancy following ovulation induction with Clomiphene citrate. Iran J Reprod Med. 2010;8:51-4.
Luo X, Lim CE, Huang C, Wu J, Wong WS, Cheng NC. Heterotopic pregnancy following in vitro fertilization and embryo transfer: 12 cases report. Arch Gynecol Obstet. 2009;280:325-29.
Aust T, O’Neill A, Cario G. Purse-string suture technique to enable laparoscopic management of the interstitial gestation of a heterotopic pregnancy. Fertil Steril. 2011;95:261‑3.
Scheiber MD, Cedars MI. Successful non-surgical management of a heterotopic an abdominal pregnancy following embryo transfer with cryopreserved-thawed embryos. Hum Reprod. 1999;14:1375-7.
Goldstein JS, Ratts VS, Philpott T, Dahan MH. Risk of surgery after use of potassium chloride for treatment of tubal heterotopic pregnancy. Obstet Gynecol. 2006;107:506-8.
Nabi U, Yousaf A, Ghaffar F, Sajid S, Ahmed MM. Heterotopic Pregnancy - A Diagnostic Challenge. Six Case Reports and Literature Review. Cureus. 2004;11(11):e6080.
