Spontaneous Second Trimester Heterotopic Pregnancy

Abstract

Abstract

Background: A heterotopic pregnancy means the presence of an intrauterine and extrauterine pregnancy at the same time. Its incidence is ∼1/7000–1/30,000 pregnancies; however, it may reach 1% because of the use of assisted reproductive technology. The diagnosis of heterotopic pregnancy is always difficult for obstetricians. Heterotopic pregnancy could be life threatening if diagnosis is delayed. Surgical treatment through laparotomy is usually needed. Case: The case of a 24-year-old woman who had a spontaneous extra- and intrauterine pregnancy is presented. In this case, there was a delay in the diagnosis of the ectopic pregnancy, leading to emergency laparotomy. Results: The intrauterine pregnancy was not affected by the laparotomy. The patient was kept on analgesics and intravenous tocolysis for 48 hours postoperatively, and was kept in the hospital up to the 7th postoperative day. She was discharged on the 8th postoperative day. Conclusions: Heterotopic pregnancy must be considered in every patient complaining of acute abdomen, even if intrauterine pregnancy is present. Every obstetrician examining women by ultrasound in early pregnancy should examine the adnexa. Early diagnosis is highly recommended in order to save the tube and the intrauterine pregnancy. (J GYNECOL SURG 30:301)