An unexpected quadruplet heterotopic pregnancy after bilateral salpingectomy and replacement of three embryos

Heterotopic pregnancy is the simultaneous occurrence of two or more implantation sites. A 25-year-old infertile patient with a history of bilateral salpingectomy, uterine septum resection, and left cornual resection was diagnosed with heterotopic pregnancy in her secondin vitrofertilization trial. She attended our clinic when she was 7-week pregnant, complaining initially of severe abdominal pain. Findings associated with peritoneal irritation were positive during the physical examination. Transvaginal ultrasound revealed right cornual ectopic pregnancy with a live fetus in the middle of the uterine cavity. Also free fluid was noted in the pelvis. A diagnosis of heterotopic pregnancy with rupture of the cornual pregnancy was made. She underwent emergency laparoscopy with aspiration of the ruptured ectopic pregnancy, suturing to the entire visible cornual margins, and assurance of good haemostasis. Her recovery was uneventful and she continued receiving care in our obstetric unit. She delivered a healthy newborn by cesarean section at term.

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Ruptured heterotopic pregnancy after assisted reproduction in a patient who underwent bilateral salpingectomy

Journal of Obstetrics and Gynaecology ◽

10.3109/01443615.2012.727045 ◽

2013 ◽

Vol 33 (2) ◽

pp. 209 ◽

Cited By ~ 4

Author(s):

L. Zhaoxia ◽

Q. Honglang ◽

C. Danqing

Keyword(s):

Assisted Reproduction ◽

Heterotopic Pregnancy ◽

Bilateral Salpingectomy

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Interstitial Heterotopic Pregnancy in a Woman Conceiving by In Vitro Fertilization After Bilateral Salpingectomy

Mayo Clinic Proceedings ◽

10.4065/76.1.90 ◽

2001 ◽

Vol 76 (1) ◽

pp. 90-92 ◽

Cited By ~ 23

Author(s):

Daniel A. Dumesic ◽

Mark A. Damario ◽

Donna R. Session

Keyword(s):

In Vitro Fertilization ◽

Heterotopic Pregnancy ◽

Vitro Fertilization ◽

Bilateral Salpingectomy

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P28.09: Repeated heterotopic pregnancy following bilateral salpingectomy

Ultrasound in Obstetrics and Gynecology ◽

10.1002/uog.4737 ◽

2007 ◽

Vol 30 (4) ◽

pp. 559-559

Author(s):

D. V. Valsky ◽

Y. Lavy ◽

S. Yagel

Keyword(s):

Heterotopic Pregnancy ◽

Bilateral Salpingectomy

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Heterotopic Quadruplet Pregnancy. Literature Review and Case Report

Medicina ◽

10.3390/medicina57050483 ◽

2021 ◽

Vol 57 (5) ◽

pp. 483

Author(s):

Brîndușa Cimpoca ◽

Amira Moldoveanu ◽

Nicolae Gică ◽

Corina Gică ◽

Anca Marina Ciobanu ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Ectopic Pregnancy ◽

Assisted Reproductive Techniques ◽

Heterotopic Pregnancy ◽

Management Options ◽

Reproductive Techniques ◽

Natural Conception

Heterotopic pregnancy is the condition where both intrauterine and ectopic pregnancy are present. It rarely occurs after natural conception, but is more common with assisted reproductive techniques, when more than one embryo is transferred. Quadruplet heterotopic pregnancy is exceedingly rare. Methods: A literature review was conducted aiming to highlight the diagnosis difficulties and the management options in heterotopic quadruplet pregnancies. Results: Nine relevant studies were identified by researching PubMed up to 2021 for “heterotopic quadruplet pregnancy”, “quadruplet intrauterine and ectopic pregnancy”, “synchronous intrauterine and ectopic pregnancy”. Conclusions: In this paper, we present a case of heterotopic quadruplet pregnancy and address the difficulty in diagnosing this condition and make formal recommendations.

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