scholarly journals Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1207
Author(s):  
Gabija Didziokaite ◽  
Monika Vitaityte ◽  
Gerda Zykute ◽  
Virginija Paliulyte ◽  
Arturas Samuilis
Keyword(s):  
Abdominal Pain ◽  
Assisted Reproductive Technology ◽  
Multidisciplinary Team ◽  
Ovulation Induction ◽  
Multiple Pregnancy ◽  
Expectant Management ◽  
Clinical Situation ◽  
Reproductive Technology ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy

Heterotopic pregnancy is a rare, difficult to diagnose and life-threatening pathology, which requires timely decisions made by an experienced multidisciplinary team. In this type of multiple pregnancy there are both intrauterine and ectopic pregnancies present. Its incidence increases in pregnancies conceived by assisted reproductive technology or in pregnancies with ovulation induction. This article presents an angular heterotopic pregnancy case in a 34-year-old multigravida. The patient was admitted on the 14th week of gestation due to abdominal pain on the left side with suspicion of heterotopic pregnancy. Transabdominal ultrasound and magnetic resonance imaging (MRI) were performed to confirm the diagnosis of heterotopic angular pregnancy in the left cornu of the uterus. Multidisciplinary team made a decision to keep monitoring the growth of both pregnancies by ultrasound while maternal vitals were stable. Due to intensifying abdominal pain, diagnostic laparoscopy was performed. No signs of uterine rupture were observed, and no additional surgical procedures were performed. Maternal status and ultrasonographic findings were closely monitored. The mass in the left cornu of the uterus did not change significantly and the fetal growth of the intrauterine pregnancy matched its gestational age throughout pregnancy. At the 41st week of gestation, a healthy female neonate was born via spontaneous vaginal delivery. The incidence rate of heterotopic pregnancy tends to grow due to an increased number of pregnancies after assisted reproductive technology and ovulation induction. It is important to always assess the risk factors. The main methods for diagnosing heterotopic pregnancies are ultrasonography and MRI. The main management tactics for heterotopic pregnancy include expectant management as well as surgical or medical termination of the ectopic pregnancy. Expectant management may be chosen as an option only in a limited number of cases, if the clinical situation meets the specific criteria. When applicable, expectant management may reduce the frequency of unnecessary interventions and help to prevent patients from its complications.

The role of inflammatory cytokines in the pathogenesis of premature labor in multiple pregnancy as a result of ART

2016 ◽  
pp. 73-76
Author(s):  
B.M. Ventskivskiy ◽  
◽  
I.V. Poladych ◽  
S.O. Avramenko ◽  
◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Inflammatory Cytokines ◽  
Proinflammatory Cytokines ◽  
Local Level ◽  
Multiple Pregnancy ◽  
Reproductive Technology ◽  
System Level ◽  
Premature Labor ◽  
Pro Inflammatory Cytokines

In recent years there has been an increase in the frequency of multiple pregnancies and the associated perinatal losses. It is a result of multiple pregnancy in ART refers to a high-risk gestation, at which premature births occur in 2 times more often than in singleton pregnancies. The objective: to determine the role of pro-inflammatory cytokines in the pathogenesis of premature labor in multiple pregnancy, as a result of assisted reproductive technology. Patients and methods. to determine the pro-inflammatory cytokines that all pregnant with bagtopliddyam held immunosorbent assay, defined concentrations of interleukin (IL) in serum and cervical mucus. Results. The analysis of the levels of pro-inflammatory cytokines (IL-1, IL-8) in the test environment, found high concentrations in the surveyed women with multiple pregnancy, due to the use of ART, compared with spontaneous multiple and singleton pregnancy. Increased concentration of proinflammatory cytokines in patients with multiple pregnancy by ART is associated with their synthesis at the system level, it stimulated foci of inflammation in the female genitals and extragenital localization. This correlates with the clinical data and statistical analysis, patients with multiple pregnancy as a result of ART had weighed infectious-inflammatory history. Conclusion. The study showed that elevated levels of proinflammatory cytokines in the systemic and local level in patients with multiple pregnancy due to ART, typical for women with miscarriage, because of the physiological course of pregnancy characterized by the predominance of anti-inflammatory cytokines that prevent rejection of the fetus as a foreign factor. Based on the data obtained proved the role of systemic inflammatory factors in the genesis of preterm labor in women with a multiple pregnancy, as a result of assisted reproductive technology. Key words: multiple pregnancy, assisted reproductive technology, premature birth, interleukine-1, interleukine-8.

Spontaneous heterotopic triplet pregnancy with intrauterine monochorionic-monoamnionic twins

2016 ◽  
Vol 5 (2) ◽  
pp. 117-119
Author(s):  
Alexander Kotlyar ◽  
Jennifer Eaton ◽  
Katherine Singh ◽  
Uma Perni
Keyword(s):  
Abdominal Pain ◽  
Assisted Reproductive Technologies ◽  
Reproductive Technologies ◽  
Heterotopic Pregnancy ◽  
Second Trimester ◽  
Triplet Pregnancy ◽  
Intrauterine Pregnancy ◽  
Chorionic Villi ◽  
Prior Use ◽  
Unusual Phenomenon

Abstract Heterotopic pregnancies are an unusual phenomenon, which have recently become more prevalent with assisted reproductive technologies (ART). Triplets that are part of a heterotopic pregnancy are exceedingly rare. Here, we describe a case of a woman who presented at 15+1 weeks of gestational age with a known monochorionic-monoamniotic intrauterine pregnancy with several days of abdominal pain with an otherwise unremarkable gastrointestinal (GI) assessment. Salpingectomy was performed, and pathology revealed chorionic villi within the fallopian tube consistent with a heterotopic triplet pregnancy. This pregnancy was conceived spontaneously. Even without the prior use of ART, physicians need to be aware of the risk of heterotopic pregnancy in a patient with a known twin gestation. In addition, this case highlights how heterotopic triplets can present even within the second trimester.

scholarly journals Heterotopic Pregnancy in a Natural Conception

2010 ◽  
Vol 1 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Sumeet N Baheti ◽  
K Jayakrishnan
Keyword(s):  
Abdominal Pain ◽  
Hemorrhagic Shock ◽  
Transvaginal Ultrasound ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Abnormal Pregnancy ◽  
Emergency Laparoscopy ◽  
Life Threatening ◽  
Natural Conception ◽  
High Index Of Suspicion

ABSTRACT Heterotopic pregnancy is rare in natural conception and most often presents as life threatening emergency like acute abdomen and hemorrhagic shock. In early unruptured stages, it presents nonspecifically, mimicking normal or abnormal pregnancy manifestations. A high index of suspicion and a definitive search for it even after confirming normal intrauterine gestation is needed. This little effort ensures a timely diagnosis and management thus preventing catastrophe. We hereby report a primigravida with unruptured heterotopic pregnancy following a natural conception, who presented as nonspecific abdominal pain. Transvaginal ultrasound was inconclusive. Emergency laparoscopy clinched the diagnosis and allowed conservative salpingostomy and continuation of intrauterine pregnancy.

scholarly journals HETEROTOPIC PREGNANCY

2006 ◽  
Vol 13 (01) ◽  
pp. 162-164
Author(s):  
FARKHUNDA AKTHAR
Keyword(s):  
Abdominal Pain ◽  
Rare Case ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Atypical Presentation ◽  
Intrauterine Pregnancy ◽  
Ectopic Gestation

A rare case of simultaneous tubal pregnancy and intrauterine pregnancy is discussed. Patient hadan atypical presentation of abdominal pain and a abnormal uterine bleeding but no period of amenorrhea. On clinicalexamination there was suspicion of ectopic gestation but ultrasonography revealed early intrauterine pregnancy alongwith luteal cyst. Because of increase severity of pain she was reviewed again. Repeat sonography findings wereconsistent with heterotopic which was confirmed by laparotomy and histopathology.

Fetal growth retardation in multiple pregnancy: anthropometrical and haemodynamic criteria of early antenatal diagnosis

2021 ◽  
Vol 50 (2) ◽  
pp. 50-54
Author(s):  
V. S. Prokhorova ◽  
N. G. Pavlova, ◽  
V. V. Kozlov ◽  
A. V. Novikova
Keyword(s):  
Assisted Reproductive Technology ◽  
Fetal Growth ◽  
Growth Retardation ◽  
Antenatal Diagnosis ◽  
Multiple Pregnancy ◽  
Mathematic Model ◽  
Reproductive Technology ◽  
Fetal Growth Retardation ◽  
Spontaneous Pregnancy ◽  
Ultrasound Investigation

Ultrasound investigation o f feta l biometry and haemodynamic indices in fetoplacental system during pregnancy since 14 weeks was carried out in 53 women havingtwins as a result o f spontaneous pregnancy or using o f assisted reproductive technology methods. The frequency and possible reasons oflU G R development in multiple pregnancy were analyzed. To predict the possibility o f IUG R in II and III trimester o f multiple pregnancy the mathematic model was worked out based on the standard fetometric indices measuring at 14-16 weeks o f pregnancy.

The course and outcomes of multiple pregnancy following assisted reproductive technology

2020 ◽  
Vol 10_2020 ◽  
pp. 71-77
Author(s):  
Kalashnikov S.A. Kalashnikov ◽  
Sichinava L.G. Sichinava ◽  
Keyword(s):  
Assisted Reproductive Technology ◽  
Multiple Pregnancy ◽  
Reproductive Technology
Sign in / Sign up

Export Citation Format

Share Document