Heterotopic pregnancy in a natural conception cycle presenting with tubal rupture: a case report and review of the literature

Varras, M; Akrivis, Christodoulos; Hadjopoulos, G; Antoniou, Nikolaos

doi:10.1016/s0301-2115(02)00154-9

Cited by 43 publications

(56 citation statements)

References 17 publications

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“…Laparoscopy or laparotomy with minimal manipulation of the uterus should be the standard form of treatment in these patients [5]. In all of our cases laparotomy was done with salphingectomy in two cases and salpingostomy with primary repair of tube in one case.…”

Section: Discussionmentioning

confidence: 82%

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Ruptured Heterotopic Pregnancy: A Rare Cause for Hemoperitoneum; Report of Three Cases from Kashmir, India

et al. 2010

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Heterotopic pregnancy has been found in various forms but is still a rare event in the natural conception cycles, occurring in less than 1:30000 pregnancies with the incidence rising to 1:100 to 1:500 pregnancies duo to assisted reproductive technologies. Delay in diagnosing the condition can be fatal for both the mother and the fetus. Three patients aged 28, 31 and 26 years presented with amenorrhea of ten, eight and twelve weeks duration respectively with signs of peritonism and shock. Investigations revealed intra and extra uterine pregnancies in all the three cases with the rupture of the extra uterine pregnancies. All the cases were operated and first two cases were followed up postoperatively till the delivery of the term live babies. The third case is still under our follow up. A high index of suspicion by a general surgeon is needed in arriving at a prompt diagnosis of ruptured heterotopic pregnancy so that rapid resuscitation, heart sparing anesthesia and expeditious surgery is carried out for both maternal and intrauterine fetal wellbeing.

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Section: Discussionmentioning

confidence: 82%

“…Identification of the ectopic pregnancy by sonography has a low sensitivity (0.56) [1]. Serial samples of β HCG can also be misleading in cases of heterotopic pregnancy [5]. Abdominal paracentesis may diagnose a case of haemoperitonium but even if it is negative a hetrotopic pregnancy can not be till excluded.…”

Section: Discussionmentioning

confidence: 99%

Ruptured Heterotopic Pregnancy: A Rare Cause for Hemoperitoneum; Report of Three Cases from Kashmir, India

et al. 2010

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“…9 Heterotopic pregnancy is possible with natural conception and the survival of the intrauterine fetus is feasible. 10 The presence of an intrauterine pregnancy tends to impede the early diagnosis and precludes definitive intervention for the ectopic pregnancy. The illustrated case did not have any risk factor for the heterotopic pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Acute Presentation of Spontaneous Heterotopic Pregnancy Presenting with Tubal Rupture

Das

Biswas

Roy

2014

Int Jour of Biomed Res

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“…The four common clinical signs of heterotopic pregnancies are abdominal pain, adnexal mass, peritoneal irritation and uterine fundus larger than menstrual dates [1]. Vaginal bleeding occurs rarely in heterotopic pregnancy, compared to ectopic pregnancy [7].…”

Section: Discussionmentioning

confidence: 99%

“…First found during an autopsy in 1708 [1], heterotopic pregnancy occurs in 1:30,000 of natural conceptions [2]. With increasing usage of assisted reproduction, the frequency of heterotopic pregnancies was cited to be between 1:100 and 1:7,000 [3,4].…”

Section: Introductionmentioning

confidence: 99%

Think Heterotopic: A Case Report of Heterotopic Pregnancy Detected on Thorough Ultrasonography

Kwok

2012

J Med Cases

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We present a case report of heterotopic pregnancy picked up on thorough ultrasonography in a clinically stable 22-year-old patient with low risk factors. Heterotopic pregnancy is a rare obstetrics phenomenon and carries a significant maternal morbidity and mortality due to the risk of rupture of the ectopic pregnancy. Clinicians and sonographers tend to be lulled into a false sense of security when an intrauterine gestation sac is seen. This results in inadequate inspection of the adnexae and remaining structures during ultrasonography despite a strong initial clinical suspicion of ectopic pregnancy. Hence, a thorough ultrasonography and holistic approach is needed in managing these patients, especially when there is a high suspicion of ectopic pregnancy or in the presence of pelvic free fluid even when an intrauterine pregnancy is identified. A new dictum 'Think ectopic. If intrauterine gestation is seen, think heterotopic' needs to be adopted.

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Heterotopic pregnancy in a natural conception cycle presenting with tubal rupture: a case report and review of the literature

Cited by 43 publications

References 17 publications

Ruptured Heterotopic Pregnancy: A Rare Cause for Hemoperitoneum; Report of Three Cases from Kashmir, India

Ruptured Heterotopic Pregnancy: A Rare Cause for Hemoperitoneum; Report of Three Cases from Kashmir, India

Acute Presentation of Spontaneous Heterotopic Pregnancy Presenting with Tubal Rupture

Think Heterotopic: A Case Report of Heterotopic Pregnancy Detected on Thorough Ultrasonography

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