Spontaneous heterotopic pregnancy with tubal rupture
Keywords:Ectopic pregnancy, Heterotopic pregnancy, Ultrasonography
Heterotopic pregnancy is the coexistence of intrauterine pregnancy (IUP) and extrauterine gestation. It is a rare and dangerous life-threatening condition that is difficult to diagnose and easily missed. The incidence in the general population is estimated to be 1 in 30,000. We report a case of a 24-year-old multigravida who was seen in the emergency department with a diagnosis of a ruptured ectopic pregnancy. A careful ultrasound assessment led to the diagnosis of a heterotopic pregnancy despite lack of any notable risk factors. Immediate surgical intervention with supportive measures resulted in a successful outcome. An obstetrician should keep in mind the occurrence of a heterotopic pregnancy while dealing with pregnant females. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.
Govindarajan MJ, Rajan R. Heterotopic pregnancy in natural conception. J Hum Reprod Sci. 2008 Jan;1(1):37-38.
Hassani KI, Bouazzaoui AE, Khatouf M, Mazaz K Heterotopic pregnancy: A diagnosis we should suspect more often. J Emerg Trauma Shock. 2010;3:304.
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.
Devoe RW, Pratt JH. Simultaneous intrauterine and extrauterine pregnancy. Am J Obstet Gynecol. 1948;56:1119-26.
McDonald J, Sebrina DP. Abdominal Pain In The Adolescent Female. Clin Pediatr Emerg Med. 2002;3:33-44.
Berger MJ, Taymor ML. Simultaneous intrauterine and tubal pregnancies following ovulation induction. Am J Obstet Gynecol. 1972;113:812-3.
Chen KH, Chen LR. Rupturing heterotopic pregnancy mimicking acute appendicitis. Taiwan J Obstet Gynecol. 2014;53:401-3.
Tal J, Haddad S, Gordon N, Timor-Tritsch I. Heterotopic pregnancy after ovulation induction and assisted reproductive technologies: a literature review from 1971 to 1993. Fertil Steril. 1996;66:1-12.
Bright DA, Craupp FB. Heterotopic pregnancy: a re-evaluation. J Am Board Fam Pract. 1990;3:125-8.
Fernandez H, Lelaidier C, Doumerc S, Fournet P, Olivennes F, Frydman R. Nonsurgical treatment of heterotopic pregnancy: a report of six cases. Fertil Steril. 1993;60(3):428-32.
Diallo D, Aubard Y, Piver P, Baudet JH. Grossesse hétérotopique: à propos de cinq cas et revue de la littérature. J Gynecol Obstet Biol Reproduction. 2000;29(2):131-14.
Allison JL, Aubuchon M, Leasure JD, Schust DJ. Hyperosmolar glucose injection for the treatment of heterotopic ovarian pregnancy. Obstet Gynecol. 2012;120(2):449-52.