Spontaneously conceived heterotopic pregnancy with abdominal pregnancy implanted on the vesicouterine pouch: A case report and literature review

Abstract

We report the case of a 36‐year‐old woman with spontaneously conceived heterotopic pregnancy with abdominal pregnancy. She visited the hospital at 5 weeks and 4 days of gestation and transvaginal ultrasonography revealed a normal intrauterine pregnancy. Two days later, she was urgently transported to the hospital due to extreme abdominal pain. Emergent laparotomy was performed to investigate the cause of massive intraperitoneal bleeding, which was confirmed to have been due to an abdominal pregnancy that implanted on the vesicouterine pouch. The hematic mass, including chorionic villi, was successfully removed from the peritoneum. The subsequent course of the intrauterine pregnancy was uneventful and a healthy baby was born at term. To the best of our knowledge, this is an extremely rare case report of a spontaneously conceived heterotopic abdominal pregnancy, in which the intrauterine pregnancy showed a successful outcome despite the collapse of the abdominal pregnancy at a very early stage.

Spontaneous heterotopic pregnancy

“…SH spontană este extrem de rară și este descrisă în literatura engleză ca cazuri clinice separate [1,2,4,5,[7][8][9][10][11][12][13][14][15][16]]. Oancea M. și coaut.…”

“…În SH, în marea majoritate a cazurilor, a fost observată o sarcină uterină monofetală [1,2,4,5,7,10,12,15,16,18,21,24,25,26,28] și numai în câteva cazuri a fost descrisă o sarcină uterină multiplă [13,14,20,27]. Așadar, conform Bataille P. și coaut.…”

“…(2023), sarcina ectopică a fost localizată în: ampula trompei uterine (82.1%), regiunea istmică (8.9%) și regiunea interstițială (7.1%) [24]. Variante rare de gestație ectopică în SH includ: bontul trompei uterine după tubectomie [21,24], sarcina interstițială [27,31], în zona cicatricei uterine după cezariană [11], cervicală [32,33,34], ovariană [10,24,25], abdominală [15,24], abdominală (în omentum mare) după tubectomie bilaterală [26], spațiul retroperitoneal [23].…”

A case report of dangerous pelvic infundibulum ligament in the second trimester of pregnancy with massive hemorrhage

“…Abdominal pregnancy causes severe complications such as abdominal hemorrhage and abdominal cavity organ rupture, which account for its mortality rate 7.7 times that of tubal pregnancy and 89.9 times that of intrauterine pregnancy. [ 2 – 4 ] Here, we report a case of ovarian ligament propria implantation at 13 weeks of gestation, along with ovarian artery rupture and massive hemorrhage.…”

Conservative Management of Heterotopic Pregnancy: A Case Report and Review of Literature

“…Data from the United States indicate that its incidence in pregnancies conceived with the help of ART was 1.5 per 1000 pregnancies between 1999 and 2022 [ 3 ]. The most common abnormal location is the fallopian tube, but other abnormal locations may coexist with an intrauterine pregnancy, such as the cervix [ 4 ], caesarean scar [ 5 ], ovary [ 6 ], or abdominal pregnancy [ 7 ]. Due to the rare incidence of this complication, no management standards have been developed anywhere.…”