Heterotopic Pregnancy: Successful Management by Laparoscopic Salpingectomy in First Trimester and Continuation of Intrauterine Pregnancy until Term.

2017 ◽  
Vol 10 (3) ◽  
pp. 139-141
Author(s):  
Rajendra Shitole ◽  
Sharankumar Kavalgi ◽  
Hemant Deshpande
Keyword(s):  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Successful Management ◽  
Intrauterine Pregnancy ◽  
Laparoscopic Salpingectomy

scholarly journals A rare case of spontaneous heterotopic pregnancy with successful pregnancy outcome following laparoscopic management of coexisting ruptured tubal pregnancy in Non-ART set up

2018 ◽  
Vol 7 (6) ◽  
pp. 2515
Author(s):  
G. D. Maiti ◽  
Tony Jose ◽  
Shilpa Gupta ◽  
Vibhu Chatterjee
Keyword(s):  
Pregnancy Outcome ◽  
Rare Case ◽  
First Trimester ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Successful Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Set Up ◽  
Laparoscopic Salpingectomy

Heterotopic pregnancy is a rare clinical condition where both intrauterine (IU) and extra uterine pregnancy coexists. In a non-ART set up diagnosis of tubal ectopic pregnancy becomes challenging and difficult with coexisting intrauterine viable pregnancy, even when presents with ruptured form. Author is presenting one of his challenging experience in managing successfully such type of heterotopic ruptured tubal pregnancy in first trimester where extra uterine ruptured tubal pregnancy was addressed by laparoscopic salpingectomy under spinal anaesthesia with minimal uterine manipulation to continue intrauterine pregnancy till term and thus had a successful pregnancy outcome.

scholarly journals Heterotopic pregnancy: case report of a successful first trimester metacyesis management and a viable third trimester outcome

2018 ◽  
Vol 8 (1) ◽  
pp. 332
Author(s):  
Arvind Kumar Singh ◽  
Shazia Khan
Keyword(s):  
Case Report ◽  
Maternal Morbidity ◽  
Assisted Reproductive Technologies ◽  
First Trimester ◽  
Reproductive Technologies ◽  
Heterotopic Pregnancy ◽  
Third Trimester ◽  
Intrauterine Pregnancy ◽  
The Past ◽  
Maternal Morbidity And Mortality

Heterotopic pregnancies are rare combined intra and extrauterine pregnancies, the incidence of which has shown an increase over the past decade with the rising trend in assisted reproductive technologies (0.75-1.5%). Authors report a case of a 29 year old primigravida, a post IVF conception who presented at 6 weeks POG with a ruptured tubal and a viable intrauterine pregnancy. She underwent an emergency laparoscopic right salpingectomy and continued with her intrauterine pregnancy successfully till term. The article emphasizes the need of scanning the adnexa carefully in early pregnancy to diagnose and manage heterotopic pregnancy as early as possible to prevent catastrophic haemorrhage and maternal morbidity and mortality later.

scholarly journals Laparoscopic management of heterotopic pregnancy in an IVF conception

2018 ◽  
Vol 7 (3) ◽  
pp. 1255 ◽  
Author(s):  
Nitin H. Shah ◽  
Riddhi J. Shah ◽  
Swapnali Kshirsagar
Keyword(s):  
Minimally Invasive ◽  
Spinal Anaesthesia ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Laparoscopic Management ◽  
Reproductive Techniques ◽  
Laparoscopic Salpingectomy

Heterotopic Pregnancy cases are on the rise in the era of Artificial Reproductive Techniques and managing these pregnancies can be challenging especially in safeguarding the precious intrauterine pregnancy. These were traditionally managed by laparotomy and there are few cases reported wherein salpingectomy is done laparoscopically. We would like to report this case of a 7 weeks intrauterine pregnancy with 5 weeks tubal ectopic treated by laparoscopic salpingectomy under spinal anaesthesia while safeguarding the intrauterine viable gestation. In the light of increased incidence of abnormal implantations and growing demand and expertise of minimally invasive surgeries, laparoscopy is the treatment of choice for heterotopic pregnancies, especially in the interest of the intrauterine pregnancy.

scholarly journals Diagnosis of Heterotopic Pregnancy Using Ultrasound and Magnetic Resonance Imaging in the First Trimester of Pregnancy: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sue Yazaki Sun ◽  
Edward Araujo Júnior ◽  
Julio Elito Júnior ◽  
Liliam Cristine Rolo ◽  
Felipe Favorette Campanharo ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Power Doppler ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Resonance Imaging ◽  
Good Continuation ◽  
Intrauterine Pregnancy

Heterotopic pregnancy is a condition characterized by implantation of one or more viable embryos into the uterine cavity while another one is implanted ectopically, particularly into the uterine tube. Its occurrence has increased drastically over the last few years due to assisted reproduction procedures. In general, the diagnosis is made during the first trimester by using endovaginal two-dimensional ultrasound (2DUS), through observing a complex para- or retrouterine mass in association with a viable uterine pregnancy. However, under some conditions such as atypical ultrasonographic presentations, 2DUS does not clarify the situation whereas magnetic resonance imaging (MRI) of the pelvis is able to do so. We present the case of a pregnant woman in her fifth pregnancy, with a clinical condition of lower abdominal pain and pallor. Endovaginal 2DUS showed a complex voluminous mass in the left pelvic region in association with a viable intrauterine pregnancy. 2DUS in power Doppler mode showed “ring” vascularization, compatible with an ectopic gestational sac. MRI was of great importance in that it suggested that the mass had hematic content, which together with the clinical features, indicated that laparotomy should be performed. This surgical choice was essential for the woman to achieve a clinical improvement and for good continuation of the intrauterine pregnancy.

scholarly journals Heterotopic pregnancy: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Tamer Ali ◽  
Mohamed A. Tawab ◽  
Mona Abdel Ghaffar ElHariri ◽  
Alaa A. Ayad
Keyword(s):  
Abdominal Pain ◽  
Adnexal Mass ◽  
Stable Condition ◽  
Lower Abdominal Pain ◽  
Rare Condition ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Laboratory Findings ◽  
The Right

Abstract Background Heterotopic pregnancy describes the occurrence of two pregnancies in different implantation sites simultaneously, which is rare, yet it is a challenge to diagnose such a problem due to complex clinical and laboratory findings. In the current study, we present a case of first trimester heterotopic pregnancy diagnosed by ultrasound (US) and magnetic resonance imaging (MRI) and was managed successfully. Case presentation A 22-year-old primigravida lady with spontaneous pregnancy was presented by increasing lower abdominal pain for 5 days with brownish vaginal discharge, nausea, and vomiting episodes. Trans-abdominal and endovaginal ultrasound was performed and revealed a viable intrauterine pregnancy of 8 weeks and 1 day, associated with a heterogeneous complex right adnexal mass. MR imaging revealed a right adnexal mass intimately anterior to the normal right ovary. Laparascopy was done; it revealed a distended right fallopian tube with pregnancy while the right ovary was not seen (impeded in the pouch of Douglas), and right salpingectomy was done. The specimen was sent for histopathology. The patient tolerated the procedure well and was then taken to the recovery room in stable condition. The histopathological report confirmed the diagnosis of ectopic pregnancy. Conclusion However, heterotopic is a rare condition, any pregnant woman presenting with alarming abdominal pain and adnexal abnormality; heterotopic pregnancy should be among the differential diagnosis possibilities. The patient should be thoroughly investigated using ultrasound and MRI if needed, to exclude this rare diagnosis and allow on-time proper management.

scholarly journals Vaginal Delivery at Term in a Woman with a Spontaneous Heterotopic Pregnancy Treated with Laparoscopic Salpingectomy

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Michail Diakosavvas ◽  
Nikolaos Blontzos ◽  
Georgios Daskalakis ◽  
Athanasios Protopapas ◽  
Nikolaos Kathopoulis ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Vaginal Delivery ◽  
Clinical Symptoms ◽  
Lower Abdominal Pain ◽  
Major Complication ◽  
Heterotopic Pregnancy ◽  
Clinical Image ◽  
Intrauterine Pregnancy ◽  
Beta Hcg ◽  
Laparoscopic Salpingectomy

Background. The coexistence of an intrauterine pregnancy and an ectopic pregnancy (heterotopic pregnancy) is an extremely rare, yet major, complication during pregnancy. The early diagnosis of a heterotopic pregnancy is of great importance for fetal viability, maternal safety, and the progression of an uncomplicated intrauterine pregnancy. Case Presentation. We report a case of a naturally conceived heterotopic tubal pregnancy in a 37-year-old primigravida. The patient presented with continuous, dull, lower abdominal pain and a positive urine pregnancy test which was conducted a week prior to the start of the pain. The patient was hospitalized, and based on the clinical image and after strict monitoring, she was diagnosed with a heterotopic pregnancy. She was treated with laparoscopic salpingectomy after the rupture of the ectopic pregnancy while the desired intrauterine gestation continued without any complications. The pregnancy resulted in the birth of a healthy infant through vaginal delivery. Discussion. Strict monitoring with multiple sonographic evaluations should always be conducted in women with abnormal serum beta-hCG, adnexal abnormalities, or clinical symptoms, while heterotopic pregnancy should be in differential diagnosis and treatment should not be delayed since emerge management is important for the progression of the intrauterine pregnancy.

scholarly journals A unique case of diagnosis of a heterotopic pregnancy at 26 weeks – case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Kajdy ◽  
Katarzyna Muzyka-Placzyńska ◽  
Dagmara Filipecka-Tyczka ◽  
Jan Modzelewski ◽  
Marek Stańczyk ◽  
...  
Keyword(s):  
Gestational Age ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Rare Condition ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Heterotopic Pregnancy ◽  
Free Fluid ◽  
Intrauterine Pregnancy ◽  
Unique Case

Abstract Background Heterotopic pregnancy (HP) is a rare condition when at least two pregnancies are present simultaneously at different implantation sites and only one located in the uterine cavity. The majority of cases are diagnosed in the first trimester. Case presentation We present a unique case of HP diagnosed at 26 weeks of spontaneous pregnancy in a patient without any relevant risk factors. We performed an extensive review of HP cases from MEDLINE (PUBMED) published in English between 2005-2019 to prove this case's uniqueness. A 24-year-old woman presented because of threatened preterm birth. Despite treatment, pain aggravated, without progression of labor. An emergency ultrasound exam revealed free fluid in the abdominal cavity. Suspicion of active bleeding prompted the medical team to perform an exploratory laparotomy. The surgery team found a ruptured heterotopic pregnancy. This was an unexpected cause of nontraumatic hemoperitoneum at such advanced gestational age. The postoperative period was uneventful, and the intrauterine pregnancy continued to term. The final review included 86 out of 124 records. A total number of 509 cases were identified, but not all of them had complete data. The maximum reported gestational age at the time of diagnosis was 16 weeks of pregnancy, while our case became symptomatic and was diagnosed at 26 weeks of pregnancy. Conclusions Regardless of pregnancy age, HP can be a cause of hemoperitoneum, and it should be included in the differential diagnosis of acute abdomen in the second trimester.

scholarly journals HETEROTOPIC PREGNANCY – CASE REPORT

2020 ◽  
Vol 73 (4) ◽  
pp. 828-830
Author(s):  
Michal Swiniarski ◽  
Monika Sadkowska ◽  
Grzegorz Roman ◽  
Lukasz Szeszko ◽  
Olimpia Sipak-Szmigiel
Keyword(s):  
Caesarean Section ◽  
Ectopic Pregnancy ◽  
First Trimester ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Simultaneous Occurrence ◽  
Free Fluid ◽  
Intrauterine Pregnancy ◽  
Normal Delivery ◽  
Reproductive Techniques

Heterotopic pregnancy is the simultaneous occurrence of intrauterine and ectopic pregnancy. This situation is very rare (1:30 000 pregnancies), while recently, with the development of assisted reproductive techniques, the incidence has increased to 1:100 – 1:500 pregnancies. The aim of the study is to present the situation of coexistence of intrauterine pregnancy and ruptured tubal pregnancy. The case concerns a 32-year-old patient in the 12th week of the second pregnancy in whom the only risk factor was the state after Caesarean section and thus possible intraperitoneal adhesions. The ultrasound revealed normal intrauterine pregnancy and a very large amount of free fluid in the smaller pelvis. After immediate surgical intervention, a ruptured right tubal pregnancy was found. Right fallopian tube was removed. After the operation, the patient with the preserved intrauterine pregnancy was discharged from the ward. Further intrauterine pregnancy was normal. Delivery by Caesarean section. Conclusions: The described case indicates that the existence of intrauterine pregnancy does not exclude the existence of ectopic pregnancy and emphasizes the great importance of correctly and accurately carried out ultrasound examination in the first trimester of pregnancy along with appendicitis assessment. Early diagnosis of heterotopic pregnancy reduces the risk of complications.

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