DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20161720

A rare case of spontaneous heterotopic pregnancy presented as ruptured ectopic pregnancy

Amita Yadav, Preeti Yadav, Veena Gupta

Abstract


Heterotopic gestation, although common with assisted reproductive techniques, is very rare in natural conception. A high index of suspicion can help in timely diagnosis and appropriate intervention. We report a case of 30 year old patient who was treated for a heterotopic pregnancy. She had taken treatment for genital tuberculosis in the past. The patient presented acutely with a ruptured tubal pregnancy in shock and this was managed by emergency laparotomy. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.

Keywords


Heterotopic pregnancy, Ectopic pregnancy

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References


Duverney JG, in Jombert CA (ed): Oeuvres Anatomiques. Paris 1708, p 355.

DeVoe RW, Pratt JH. Simultaneous intrauterine and extrauterine pregnancy. Am J Obstet Gynecol. 1948;56(6):1119-26

Bello GV, Schonolz D, Moshirpur J, Jeng DY, Berkowitz RL: Combined pregnancy: the Mount Sinai experience. Obstet Gynecol Surv. 1986;41(10):603-13.

Press GM, Martinez A. Heterotopic pregnancy diagnosed by emergency ultrasound. J Emerg Med. 2007;33(1):25-7.

Mj G, R R. Heterotopic pregnancy in natural conception. J Hum Reprod Sci. 2008;1(1):37-8.

Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, et al. Saving Mothers' Lives: Reviewing maternal deaths to make motherhood safer: 2006-2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG. 2011;118 Suppl 1:1-203.

Govindarajan MJ, Rajan R. Heterotopic pregnancy in natural conception. J Hum Reprod Sci. 2008;1(1):37-8.

Hirose M, Nomura T, Wakuda K, Ishguru T, Yoshida Y. Combined intrauterine and ovary pregnancy: A case report. Asia Oceana J Obstet Gynaecol. 1994;20:20-5.

Peleg D, Bar-Hava, Neaman-Leaven M, Ashkena, Ben-Rafaelz J. Early diagnosis and successful non surgical treatment of viable combined intrauterine and cervical pregnancy. Fertil Steril. 1994;62:405.

Alsunaidi M: An unexpected spontaneous triplet heterotopic pregnancy. Saudi Med J. 2005;26(1):136-8.

Jeong H, Park I, Yoon S, Lee N, Kim H, Park S: Heterotopic triplet pregnancy with bilateral tubal and intrauterine pregnancy after spontaneous conception. Eur J Obstet Gynecol. 2009;142:161-2.

Tal J, Haddad S, Gordon N: Heterotopic pregnancy after ovulation induction and assisted reproductive technologies: a literature review from 1971 to 1993. Fertil Steril. 1996;66:1-12.

Marcus SF, Macnamee M, Brinsden P: Heterotopic pregnancies after in vitro fertilization and embryo transfer. Hum Repro. 1995;10:1232-6.

Sohail S: Haemorrhagic corpus luteum mimicking heterotopic pregnancy. J Coll Phys Surg Pak 2005, 15:180-181.

Louis-Sylvestre , Morice P, Chapron C, Dubuisson : The role of laparoscopy in the diagnosis and management of heterotopic pregnancy. Hum Rep. 1997;12(5):1100-2.

Lialios GA, Kallitsaris A, Kabisios T, Messinis IE. Ruptured heterotopic interstitial pregnancy: rare case of acute abdomen in a Jehovah′s witness patient. Fertil Steril. 2008;90:1200.e15-7.

Oyawoyea S, Chander B, Pavlovic B, Hunter J, Gandir AA. Heterotopic pregnancy: successful management with aspiration of cornual/interstitial gestational sac and installation of small dose of methotrexate. Fetal Diagn Ther. 2003;18:1-4.

Chandra PC, Schiavello HJ, Briggs SL, et al. Heterotopic pregnancy with term delivery after rupture of a first-trimester tubal pregnancy. A case report. J Reprod Med. 1999;44(6):556-8.

Mol BW, Van der Veen F, Bossuyt PM. Implementation of probabilistic decision rules improves the predictive values of algorithms in the diagnostic management of ectopic pregnancy. Hum Reprod. 1999;14:285562.

Mol BW, Van der Veen F, Bossuyt PM. Implementation of probabilistic decision rules improves the predictive values of algorithms in the diagnostic management of ectopic pregnancy. Hum Reprod. 1999;14:285562.