Early Diagnosis of Heterotopic Pregnancy in a Primigravid Without Risk Factors in the Emergency Department

O’Donnell, Rachel; Siacunco, Elizabeth; Quesada, Daniel; Barkataki, Kieron; Aguìñiga-Navarrete, Phillip

doi:10.5811/cpcem.2019.1.41312

Cited by 7 publications

(10 citation statements)

References 4 publications

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“…The majority of heterotopic pregnancies presented with abdominal pain as the main symptom [18,19], as shown by our review. Other presentations include left lower quadrant pain or right lower quadrant pain, vaginal spotting or bleeding [20][21][22].…”

Section: Resultsmentioning

confidence: 99%

Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes

et al. 2020

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Background and objective: Spontaneous heterotopic pregnancy (SHP) is a rare condition represented by the synchronous coexistence of an intrauterine and an ectopic pregnancy. It rarely occurs with natural conception and is usually a consequence of assisted reproductive techniques. Diagnosis of SHP can be a challenge for the clinician. The evolution of the intrauterine pregnancy is dependent on many factors, such as the location of the heterotopic pregnancy, gestational age at the time of diagnosis, the surgical procedure, the presence of other risk factors, early or delayed management. The aim of this systematic review of the literature was to extract existing evidence on spontaneous heterotopic pregnancy with otherwise unaffected intrauterine pregnancy. Materials and Methods: From a total of 1907 database entries identified in PubMed, EMBASE and Cochrane reviews, we selected 18 papers for narrative synthesis, for which we explored the diagnostic options, treatment, and outcome of these extremely rare epidemiologic occurrences. Manuscripts were assessed using the CARE guidelines for reporting case reports. Results: The main symptom was abdominal pain, and the preferred treatment approach was surgical, more precisely, using a laparoscopic approach. Most cases presented no risk factors, and the diagnosis was mostly made in the first semester. Conclusions: Normal follow-up and evolution of intrauterine pregnancy have been observed regardless of surgical approach (open or laparoscopic). Early diagnosis and treatment are advised, as they impact maternal and fetal outcomes. Evidence on this topic is scarce, predominantly comprised of case reports with variable degrees of adherence to dissemination guidelines. More studies on this topic are required to optimize care protocols for this type of pregnancy.

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Section: Resultsmentioning

confidence: 99%

Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes

et al. 2020

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“…Data show that more than half of these cases proceed as a normal IUP after treatment of the EUP. 13 The lesson to learn from this case report is that once a EUP is detected, clinicians tend to forget the possibility of a coexisting IUP or classify this as a pseudogestational sac. Examiners should take extra care when performing the ultrasound in all women of reproductive age with clinical symptoms, since the presence of an EUP does not exclude an IUP and vice versa, even if it is an extremely rare situation.…”

Section: Discussionmentioning

confidence: 95%

“…Luckily, if diagnosed early, HP has a favorable prognosis. Data show that more than half of these cases proceed as a normal IUP after treatment of the EUP 13 …”

Section: Discussionmentioning

confidence: 99%

Persistent increase of β‐hCG level after salpingectomy in tubal pregnancy: Good or bad news?

Ribeiro

Amann

Alejandre

et al. 2021

Clinical Case Reports

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“…While heterotopic pregnancy (HP) is rare, its frequency increased with the advent of fertility treatment and reproductive technologies [9].…”

Section: Discussionmentioning

confidence: 99%

A case report of heterotopic pregnancy

Leandro¹,

Torriente²,

Herrera³

2020

World J. Adv. Res. Rev.

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Heterotopic pregnancy (HP) refers to the simultaneous presence of intrauterine pregnancy (IUP) and ectopic pregnancy (EP), which is very rare but a potentially life-threatening condition. HP can be spontaneous or the subsequence of assisted reproductive technology (ART). A 23 years old patient, primigravida who came to the emergency department presenting lower abdominal pains for four days accompanied by moderate dark vaginal bleeding. The sonar reported Heterotopic Pregnancy. Laparotomy was performed and a clinically 13 week's fetus was found in the Pouch of Douglas. The other embryo that showed fetal activity and no other complication was left inside the uterus. The patient was seen in the hospital every month till delivered by cesarean section an alive baby. Heterotopic pregnancy is now more frequent because of reproductive assisted techniques. Doctors should keep a high index of suspicion in patients with intrauterine pregnancies accompanied by abdominal pains.

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Early Diagnosis of Heterotopic Pregnancy in a Primigravid Without Risk Factors in the Emergency Department

Cited by 7 publications

References 4 publications

Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes

Spontaneous Heterotopic Pregnancy with Unaffected Intrauterine Pregnancy: Systematic Review of Clinical Outcomes

Persistent increase of β‐hCG level after salpingectomy in tubal pregnancy: Good or bad news?

A case report of heterotopic pregnancy

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