Heterotopic Pregnancy: Challenges in Diagnosis and Management

Abstract

Objectives: 1) To study the obstetric outcome in two women with heterotopic pregnancy, 2) To report the challenges faced during management of these pregnancies. Design: Case study of two heterotopic pregnancies managed by us. Setting: RL Jalappa Hospital and Research Hospital. Patients: Two women with heterotopic pregnancy. Interventions: Laparotomy and management of ectopic component. Main Outcome Measures: Pregnancy outcomes following surgery. Results: Both pregnancies continued with one live birth at 36 weeks and one preterm delivery at 29 weeks with neonatal death subsequently. Conclusion: Pregnancy outcome after surgery for heterotopic pregnancy is guarded and is at high risk for preterm birth. Salpingostomy is a good option when faced with dilemma of whether it is hematosalpinx or ectopic pregnancy instead of salpingectomy.

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“…3,4 Risk factors such as sexual transmited infections, tubal surgery, and also ovulation induction with gonadotropin and clomiphene citrate could also increase the incidence of heterotopic pregnancy. 5,6 This confirms that the significance of detection of risk in pregnant woman in order to increase awareness of diagnosing this rare condition. In this written case, there were no risk factors, in other words it is concluded that this case is a spontaneus HP, which is a very rare condition.…”