Spontaneous Heterotopic Pregnancy: Diagnosis and Management.
Riverside Community Hospital
heterotopic pregnancies, spontaneous abortion, salpingectomy, pelvic ultrasound
Family Medicine | Female Urogenital Diseases and Pregnancy Complications | Obstetrics and Gynecology
Background: Heterotopic pregnancies albeit rare are conceivably life-threatening if missed. With the development of assisted reproductive techniques, the incidence has increased. Confirmation of an intrauterine pregnancy (IUP) should not preclude the existence of a heterotopic pregnancy.
Case: A healthy 27-year-old patient (gravida 4, term 1, preterm 0, abortion 2, living 1) at approximately 5 weeks gestation through natural conception presented to the emergency room with acute abdominal pain and vaginal bleeding. Pelvic ultrasound showed evidence of an IUP and a right adnexal mass, raising suspicion for a heterotopic pregnancy. The patient underwent an uncomplicated laparoscopic right salpingectomy. An IUP was confirmed on ultrasound postoperatively. The patient had an early pregnancy loss at 8 weeks of gestation.
Conclusion: With a high index of suspicion from clinical presentation and pelvic imaging, heterotopic pregnancy, while rare, should not be ruled out.
Publisher or Conference
Case Reports in Obstetrics and Gynecology
Nguyen KP, Hudspeth M, Milestone H. Spontaneous Heterotopic Pregnancy: Diagnosis and Management. Case Rep Obstet Gynecol. 2022;2022:2994808. doi:10.1155/2022/2994808