Clinical Outcomes of Tubal Heterotopic Pregnancy: Assisted vs. Spontaneous Conceptions

Abstract

Background: It has not been established whether the clinical outcomes of tubal heterotopic pregnancy resulting from assisted conception are different to those of spontaneous conception. The aim of this study was to compare the clinical course and the outcome of intrauterine gestation following surgical treatment for tubal heterotopic pregnancy according to the method of pregnancy. Methods: Medical records of 13 cases of tubal heterotopic pregnancy experienced in Seoul National University Hospital during 1990–2004 and 30 case reports of tubal heterotopic pregnancy published in the Korean Journal of Obstetrics and Gynecology during 1980–2004 were reviewed retrospectively. The clinical outcomes were compared between the assisted (n = 23) and spontaneous conception groups (n = 20). Results: The assisted conception group had a significantly higher preoperative systolic blood pressure and a previous history of pelvic pathology. The spontaneous group had a higher incidence of tubal rupture and hemoperitoneum. The assisted conception group had a higher live birth rate than the spontaneous group (47.8 vs. 20%, p = 0.056). Conclusions: In tubal heterotopic pregnancy, the assisted conception group had a more favorable clinical course and intrauterine gestation outcome following surgical treatment when compared with the spontaneous conception group.

Value of transvaginal sonography in diagnosing heterotopic pregnancy after in‐vitro fertilization with embryo transfer

“…In our study, a continuing pregnancy in cases of HP was achieved in 93 of 132 patients (70.5%). This was in agreement with a previous report by Han et al ,. who showed that HP after assisted reproductive technology (ART) had better pregnancy outcomes than naturally occurring cases.…”

Spontaneous Heterotopic Pregnancy With Live Infant: Report Of Two Cases

“…Although a precise aetiology of HP is not known, factors predisposing to HP appear to be identical to those predisposing to ectopic pregnancy (12,13). Assisted reproduction increases the risk of HP because of the highly associated multiple and ectopic pregnancy rates (9,12).…”

“…Transvaginal ultrasound or laparoscopic guided aspiration and/or injection of potassium chloride, methotrexate, mifepristone (RU486), prostaglandin or hyper osmolar glucose has been described (12,13,15,18,19). While potassium chloride is nonteratogenic and commonly used, methotrexate, RU486 and prostaglandin are potentially teratogenic and should not be used (12,15).…”

Heterotopic tubal pregnancy with live twin birth complicating ovulation induction assisted cycle

“…This is in conformity with authors that reported an increase in and not in uterine twin gestation. In ARTrelated heterotopic pregnancy and an exclusive singleton intrauterine gestations in natural cycle related heterotopic pregnancy [4]. In this case report, heterotopic diagnosis was made at about seven weeks of gestation.…”

“…Heterotopic pregnancy which was first described at an autopsy study [3] was hitherto a rarity before the introduction and widespread use of ART. In natural conception cycles low frequency ranging from 1 in 10,000 to 1 in 50,000 was reported and high rates of heterotopic pregnancy from 1 in 100 to 1 in 500 was reported in ART treatment cycles [4][5][6]. The later is attributable to super ovulation induction, multiple embryo transfer with resultant increase in multiple pregnancy and ectopic pregnancy.…”