Laparoscopic resection of cornual heterotopic pregnancy after in vitro fertilization and embryo transfer leading to successful live birth

Management and outcome of heterotopic interstitial pregnancy: Case report and review of literature

“…22,23 Applying a purse string suture at the base of the interstitial pregnancy, 24 meticulous suturing of the cornual defect and the use of hemostatic agents such as Surgicell, 25 are the most frequently described techniques to achieve adequate hemostasis. 22…”

“…Most authors advise an elective cesarean section to deliver the continuing intrauterine pregnancy. 2,22,28,29 This advice is supported by peroperative findings of a thinned out 22 and even preruptured state 4 of the affected cornu, even after expectant management of a nonviable interstitial heterotopic pregnancy. 4 Nevertheless, some authors have described a successful vaginal delivery after early treatment for interstitial pregnancy.…”

“…The use of local injection of vasopressin or coagulation of the ovarian and uterine arteries are impossible when the viable intrauterine pregnancy is to be preserved. 22 Some suggest to minimize the use of coagulation techniques anyway in order to avoid tissue necrosis, which might increase the chance of uterine rupture. 22,23 Applying a purse string suture at the base of the interstitial pregnancy, 24 meticulous suturing of the cornual defect and the use of hemostatic agents such as Surgicell, 25 are the most frequently described techniques to achieve adequate hemostasis.…”

“…22 Some suggest to minimize the use of coagulation techniques anyway in order to avoid tissue necrosis, which might increase the chance of uterine rupture. 22,23 Applying a purse string suture at the base of the interstitial pregnancy, 24 meticulous suturing of the cornual defect and the use of hemostatic agents such as Surgicell, 25 are the most frequently described techniques to achieve adequate hemostasis. 22 Surgery is the only treatment option in case of cornual rupture and in second or third trimester interstitial pregnancies.…”

Heterotopic pregnancy after in vitro fertilization in a patient with distal tubal hypoplasia

“…It occurs rarely in a natural conception cycle, but more frequently in IVF, in which more than one embryo may be transferred, 1 2 even women with a history of salpingectomy. 3 It’s a challenge for clinicians to confirm this diagnosis earlier. In general practice, ectopic pregnancy was rarely considered if intrauterine pregnancy was present.…”