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.

Acute appendicitis is the most common abdominal non-obstetrical emergency in pregnant women;its management however is supported by a low level of evidence. The main objective of this studywas to evaluate the clinical management of pregnant women with acute appendicitis.We havereviewed the hospital database selecting the pregnant women with acute appendicitis managed inthe last 24 months. 8 appendectomies were performed in pregnant women. Mean age was 27.2±6.1years. All patients had a history of right lower abdominal pain of 36 hours or less. Generalanesthesia was used in 12.5% of cases and spinal anesthesia in the remaining of cases. In all casesappendectomy was performed through a McBurney’s incision with a mean operating time of 36.25minutes. There was no maternal or fetal mortality.The diagnosis of acute appendicitis ischallenging in pregnant women. A prompt, but a non-negative appendectomy should always beaimed, and no unecessary risks should be taken.

No abstract