Heterotopic quadruplet gestation with laparoscopic resection of ruptured interstitial pregnancy and subsequent successful outcome of triplets

Abdominal resection of a cornual heterotopic pregnancy using intraoperative ultrasound: case report

“…3 Vaginal bleeding may also be a less common symptom of heterotopic pregnancy compared to a typical ectopic pregnancy possibly due to the coexisting intrauterine pregnancy. 7 Beta-hCG levels demonstrate different dynamics in a heterotopic pregnancy. 1,3 Careful ultrasound examination should be undertaken and repeated as necessary, if more than one embryo is transferred even if an intrauterine pregnancy is seen.…”

“…8 The majority of heterotopic pregnancies are treated surgically with both laparoscopic and abdominal approaches having been described. 2,7,9 Other nonsurgical options include injection of Methotrexate or Potassium Chloride into the ectopic site 2 or by puncture and aspiration of fetal heart of cornual pregnancy under transvaginal ultrasound guidance 4-6 weeks after the embryo transfer. 6 While there have been several case reports advocating the use of laparoscopy as a minimally invasive approach for management of cornual pregnancies, we felt that laparotomy was better suited in this case due to the close proximity of the gestational sacs.…”

Heterotopic triplet gestation in natural conception following an IVF cycle: a rare case report

“…Triplet and quadruplet heterotropic pregnancies have also been reported though the incidence is very rare. [11][12][13] Majority of reported cases are of singleton intrauterine conception and it is more frequent following assisted conception. 8 Intrauterine gestation with hemorrhagic corpus luteal cyst, bicornuate uterus with gestation in both cavities including other surgical conditions of acute abdomen can simulate heterotopic gestation clinically and hence the difficult diagnosis.…”

Laparoscopic management of cornual heterotopic pregnancy with the use of Harmonic ACE®—a case report

“…There are 48 published cases of cornual heterotopic pregnancy [6,[15][16][17][18][19][20][21][22][23][24][25]. Only seven were from spontaneous conception, all others were from some form of assisted reproduction techniques.…”

“…They were managed mainly surgically by laparotomy and cornual resection, few were managed medically and two expectantly. Of the surgical group, only three underwent laparoscopic management [15,24,25].…”