Spontaneous Heterotopic Pregnancy Presenting with Hemoperitoneum

Mihmanlı, Veli; Kılıçkaya, Ahmet; Cetinkaya, Nilufer; Karahisar, Gülşen; Uctas, Hilal

doi:10.1016/j.jemermed.2015.02.050

Cited by 21 publications

(28 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It should be considered more likely (a) after assisted reproduction technologies, (b) with persistent or rising chorionic gonadotropin levels after dilatation and curettage for an induced/spontaneous abortion, (c) when the uterine fundus is larger than for menstrual dates, (d) when more than one corpus luteum is present in a natural conception, and (e) when vaginal bleeding is absent in the presence of signs and symptoms of ectopic gestation [7]. Furthermore, serum beta-hCG blood levels are considered to be unhelpful in making the diagnosis of HP [1]. Differential diagnosis of HP is wide: intrauterine gestation with a hemorrhagic corpus luteum can simulate H/E gestation both clinically and on ultrasound.…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous heterotopic pregnancy (HP) is an extremely rare clinical condition that represents the simultaneous occurrence of two or more implantation sites in the uterus and extra uterus [1,2]. However, the incidence of HP is considerably higher in women undergoing in vitro fertilization with embryo transfer procedures.…”

Section: Introductionmentioning

confidence: 99%

“…However, the incidence of HP is considerably higher in women undergoing in vitro fertilization with embryo transfer procedures. The assisted reproduction technologies are in constant rise, which presents a serious problem because the diagnosis of this potentially fatal condition is often difficult [1]. Early in its course, HP presents non-specifically and is often confused with other normal or abnormal pregnancy manifestations [3].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Spontaneous Heterotopic Pregnancy as an Uncommon Clinical Problem

Stanić

Roje

Matić

et al. 2020

Z Geburtshilfe Neonatol

View full text Add to dashboard Cite

Background Heterotopic pregnancy refers to the simultaneous coexistence of an intrauterine and extrauterine pregnancy. In natural conception it is very rare, with a rising incidence in patients undergoing assisted reproduction technologies. It presents a serious diagnostic problem which is often misdiagnosed. Currently, there are no standard protocols for the treatment and diagnosis of heterotopic pregnancy. Methods Two rare cases of spontaneous heterotopic pregnancy are presented. Result The first patient had a complete abortion upon which an extrauterine pregnancy was detected. The second patient, after an extrauterine pregnancy removal, progressed with an intrauterine pregnancy until full term and it ended with the delivery of a healthy infant. Conclusion Two demonstrated cases underscore that whenever abnormal adnexal findings are presented and the beta-hCG blood test is positive, the possibility of a heterotopic pregnancy should be suspected.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous Heterotopic Pregnancy as an Uncommon Clinical Problem

Stanić

Roje

Matić

et al. 2020

Z Geburtshilfe Neonatol

View full text Add to dashboard Cite

show abstract

“…It is associated with significant morbidity and mortality for both mother and fetus including hypovolemic shock, fetal loss and maternal mortality, and early diagnosis is critical [1]. While the majority of extra-uterine pregnancies are found within the fallopian tubes, those located within the abdomen increase the risk of maternal mortality up to 90 times greater than that of a normal intrauterine pregnancy [1,2]. While being relatively uncommon in spontaneous conception with 1 in 30,000 cases reported, the incidence of heterotopic pregnancy increases to 1 in 3900 when conception is enhanced with various assisted reproduction techniques (ART) including in vitro fertilization, super ovulation, and intrauterine insemination.…”

Section: Introductionmentioning

confidence: 99%

A case of spontaneous heterotopic pregnancy in natural conception complicated with hemoperitoneum

Aziz

Arronte

2020

Heliyon

View full text Add to dashboard Cite

A B S T R A C THeterotopic pregnancy, defined as simultaneous intrauterine and ectopic gestations, is an uncommon occurrence in women who conceive without assisted reproduction techniques. We present the case of 28 years old female with strong family history of multiple gestations, who presented with acute severe abdominal pain and diagnosed with spontaneous heterotopic pregnancy in natural conception. Ectopic pregnancy was successfully removed surgically to conserve the uterine pregnancy. After one week, patient presented with vaginal bleeding and diagnosed with missed abortion and lost her desired uterine pregnancy. This case report discusses the significance of early diagnosis and treatment of heterotopic pregnancy to avoid both fetal and maternal morbidity and mortality. Practitioners should carry a high index of suspicion for heterotopic pregnancy in patients presenting with common symptoms and carry a family history of multiple gestation pregnancies.

show abstract

“…It is well known that surgical treatment with HP is laparoscopy or laparotomy. In recent years, more and more patients with HP prefer to laparoscopy because of the minimally invasive approach [5]. Therefore, factors affecting prognosis after surgical therapy of HP are attention-attracting topic.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and pregnancy outcomes of heterotopic pregnancy secondary to in vitro fertilization-embryo transfer: A case series study

Zhu

Zhang

Song

2020

Preprint

View full text Add to dashboard Cite

Background: The early diagnosis and treatment of heterotopic pregnancy (HP) remain one of the biggest challenges in the field of gynecology. A coexisting intrauterine gestation makes the ectopic pregnancy in HP more difficult to diagnose. This case series analysis is designed to explore factors affecting the incidence of HP secondary to in vitro fertilization-embryo transfer (IVF-ET) and that affecting pregnancy outcomes after surgical treatment of HP.Methods: From the IVF registry system, the clinical data of 29 patients with HP and 92 with an intrauterine-only pregnancy (IUP) following embryo transfer from January 2009 to December 2017 were retrospectively analyzed.Results HP had a higher proportion of previous ectopic pregnancies, multiple abortion history ( ≧ 2 times) and tubal indication for IVF than IUP. In patients with HP, 31.03% had spontaneous abortion, 25.00% had preterm delivery and 58.62% resulted in a live birth. According to the results from logistic regression, history of multiple abortions (odds ratio (OR) 3.031, 95% confidence intervals (CI) 1.087-8.453; P=0.034), tubal infertility (OR 3.844, 95% CI 1.268-11.656; P=0.017), previous ectopic pregnancies (OR 2.303, 95% CI 0.625-8.490; P=0.021) and multiple embryo transfer ( OR 0.300, 95% CI 0.092-0.983; P=0.037) resulted in an elevated proportion of HP in IVF cycles. Incidence of HP was comparable between patients transferred with blastocyst and cleavage embryos. Shorter operative duration, smaller size of the ectopic mass and location in the ampulla of the fallopian tube were associated with higher chance of survival in the coexistent intrauterine pregnancy after surgical treatment with HP.Conclusions:The early diagnosis of HP remains a challenge. Previous history of ectopic pregnancy, multiple abortions, tubal infertility and multiple embryo transfer may be considered as meaningful risk factors of subsequent HP following IVF-ET. In patients with HP treated by surgery, shorter operative duration, smaller size of the ectopic mass and location in the ampulla of the fallopian tube means better reproductive prognosis.

show abstract

Spontaneous Heterotopic Pregnancy Presenting with Hemoperitoneum

Cited by 21 publications

References 8 publications

Spontaneous Heterotopic Pregnancy as an Uncommon Clinical Problem

Spontaneous Heterotopic Pregnancy as an Uncommon Clinical Problem

A case of spontaneous heterotopic pregnancy in natural conception complicated with hemoperitoneum

Risk factors and pregnancy outcomes of heterotopic pregnancy secondary to in vitro fertilization-embryo transfer: A case series study

Contact Info

Product

Resources

About