Heterotropic pregnancy: Rare occurrence of a 12- week ruptured right isthmo-cornual ectopic along with a viable intrauterine pregnancy.

Heterotropic pregnancy, although a rare condition, is associated with a greater frequency in assisted reproduction. It occurs in approximately 1 in 100 pregnancies conceived by in vitro fertilization (IVF) particularly when multiple embryos are transferred into the uterus. We report a case of heterotropic pregnancy following IVF with the rupture of an isthmo-cornual pregnancy at 12 weeks of gestation with uneventful progression of the intrauterine pregnancy. Laparotomy was performed for the excision of the isthmo-cornual pregnancy. The intrauterine pregnancy continued uneventfully. A female baby was delivered by elective cesarean section at 33 weeks.

A heterotopic pregnancy involving a caesarean section scar.

Heterotopic pregnancy refers to the presence of simultaneous pregnancies in two different implantation sites, generally one intra-uterine pregnancy and one extra-uterine pregnancy (usually tubal). This is a rare case of a heterotopic pregnancy involving concurrent intra-uterine pregnancy and caesarean section scar pregnancy (CSEP). CSEPs are at a high risk of bleeding and uterine rupture, carrying with them significant maternal morbidity.

Successful management of post-in-vitro fertilization cervical heterotropic pregnancy.

A case of post-in-vitro fertilization (IVF) cervical and intrauterine heterotropic pregnancy with cardiac activity in both embryos is presented. It was diagnosed in the 7(th) week of gestation by ultrasonography and cervical pregnancy was treated conservatively with intrathoracic administration of potassium chloride under transvaginal ultrasound guidance with regression of trophoblastic tissue. The intrauterine pregnancy continued and cesarean section was performed in the 31(st) week due to absent end diastolic umbilical artery fetal blood flow. A live male baby was delivered.

A Case of Heterotopic Pregnancy after Ovulation Induction / 대한산부인과학회잡지

Heterotopic pregnancy, simultaneous intrauterine and extrauterine pregnancy, classically was considered a exceedingly rare obstetrical phenomenon. But nowadays the natural incidence is increasing and especially in association with assisted reproductive technologies, such as use of variable methods for ovulation inductions, in-vitro fertilization and embryo transfer, and gamate intrafallopian transfer. In spite of the difficult early diagnosis, which is potentially dangerous to the mother and fetus, the maternal mortality, morbidity and fetal loss is low when the diagnosis is made in timely fashion and proper management is achieved. The presence of a intrauterine pregnancy dose not exclude the possibility of a extrauterine pregnancy, and in women associated with assisted reproductive technologies, the possibility of a heterotopic pregnancy should be considered. We report a case of a heterotopic pregnancy following ovulation induction and intrauterine insemination with brief review of literature.

A Case of Heterotropic Pregnancy After In Vitro Fertilization / 대한산부인과학회잡지

Heterotropic pregnancy is defined as coexistent intrauterine and ectopic pregnancy. The natural incidence is 1 per 30,000 pregnancies, but in case of ovulation induction and in vitro fertilization, it is 1 per 100 pregnancies. Heterotropic pregnancy is increased with pelvic inflammatory disease and the use of various ovulation induction method. Because heterotropic pregnancy is clinically difficult to early diagnosis, close monitoring of pregnancy is important to prevent a deleterious delay in the treatment of ectopic pregnancy, maternal morbidity, and fetal loss. We experienced a case of heterotropic pregnancy diagnosed by ultrasonography in a 32-year-old woman, who complained of vaginal spotting and low abdominal pain after in vitro fertilization and report the case with brief review of literature.