A case of spontaneous heterotopic pregnancy presenting with heart activity of both embryos

Advanced Heterotopic Pregnancy: A Case Report

“…Certainly, it is now possible to diagnose potential complications when the diagnosis reveals an intrauterine gestational sac containing an embryo and another bag containing extra-uterine embryonic echoes, especially when there is a cardiac activity is positive. However, ultrasound may be falsely reassuring; it may not clearly show the ectopic pregnancy, or may not be properly interpreted [10,11,12,16].…”

“…Some authors have proposed a list of criteria required to provide conservative treatment for GA diagnosed after 20 SA [13,16,19]: absence of malformation; no evidence of maternal or fetal decompensation; monitoring of fetal well-being; in the low insertion placental abdomen: distance of the liver and spleen; presence of amniotic fluid around the fetus; continuous hospitalization in an appropriate facility; informed consent of the patient. A multidisciplinary study should be conducted including obstetrician, pediatrician, anesthesians, closely with the couple duly informed.…”

“…Methotrexate local or general injection is not recommended because of its teratogenic and toxic effect on IUP. Surgical treatment, even by laparotomy, does not seem to disrupt the development of the IUP, subject to the manipulation of the uterus is minimal and short-term anesthesia, prophylactic tocolysis is questionable [16,17,19,20].…”

“…The treatment may be medical or surgical. Laparotomy is performed less in favor of laparoscopy [16,18,19].…”

“…A total or partial insertion into the uterus and hemorrhagic seems a less favorable prognosis for the fetus. It also keeps track of placental involution [12,16,17,18].…”