Multiple-sited (heterotopic) pregnancy after in vitro fertilization and gamete intrafallopian transfer

Molloy, D. William; Deambrosis, Warren; Keeping, Douglas; Hynes, John F.; Harrison, K.; Hennessey, John F.

doi:10.1016/s0015-0282(16)53587-0

Cited by 79 publications

(2 citation statements)

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“…HP is a rare condition. Spontaneous incidence is 1/30,000 [2], increasing with the presence of risk factors, such as a history of pelvic inflammatory disease (PID) [2] or ovarian stimulation therapy [5,[17][18][19], and rising to approximately 1 in 100 ART pregnancies [20], since the embryos that are placed in the endometrial cavity during ART procedures may not implant immediately onto the endometrium, drifting towards the tubes and predisposing to a HP [13]. Experience about HP after spontaneous conception is very limited, consisting mostly of case reports or small case series [6].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and surgical management of two cases of spontaneous heterotopic pregnancy

Sarno¹

2023

J Clin Images Med Case Rep

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Section: Discussionmentioning

confidence: 99%

Diagnosis and surgical management of two cases of spontaneous heterotopic pregnancy

Sarno¹

2023

J Clin Images Med Case Rep

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“…Heterotopic pregnancy—dizygotic twins, where one implants in the endometrial lining of the uterus and one outside of this location (i.e., ectopically)—is rare in spontaneous pregnancies (figures of approximately 1 in 4000 to 1 in 30,000 pregnancies are commonly quoted) [3–6]; it is far commoner if assisted reproductive technologies are used, with an incidence of approximately 1% [7, 8].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Heterotopic Pregnancy Associated with Massive Intraperitoneal Haemorrhage and a Normal Heart Rate, Illustrating the Concept of Relative Bradycardia

Gallaher

Tahmasebi

Sayasneh

et al. 2019

Case Reports in Obstetrics and Gynecology

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A 28-year-old, 9 and a half weeks pregnant (spontaneous conception) multigravida presented with abdominal pain and vaginal bleeding. On examination, her abdomen was diffusely tender, particularly in the right iliac fossa, though guarding was absent. Transabdominal and transvaginal ultrasonography demonstrated a viable intrauterine pregnancy and large-volume intraperitoneal haemoperitoneum; the right ovary could not be identified. The patient became hypotensive with decreased responsiveness, yet her heart rate remained normal. She proceeded to surgery where a ruptured right tubal ectopic pregnancy was identified and right salpingectomy was performed. Estimated blood loss was 3900ml. Postoperative recovery was uneventful. Ultrasound 3 days after surgery demonstrated a viable intrauterine pregnancy of gestational age 9 weeks + 1 day. The patient remains well. Her anomaly scan at 20 weeks and 6 days showed normal growth, amniotic fluid, and Dopplers with no obvious structural defects. She is currently 27 weeks pregnant and will be rescanned at 36 weeks.

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New Options for Diagnosis and Treatment of Ectopic Pregnancy

Ory¹

1992

JAMA

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The incidence of ectopic pregnancy has increased 4.5-fold in the United States since 1970. Several risk factors have contributed to this rate of increase, but the primary underlying cause remains undefined. Significant advances in the diagnosis of ectopic pregnancy have occurred during this same interval as a consequence of an enhanced understanding of the natural course of the disease. Characteristic changes in human chorionic gonadotropin levels, ultrasound findings, and more frequent use of laparoscopy have contributed to earlier, more consistent diagnosis. Advances in treatment, including tubal-conserving operations, laparoscopic approaches, and medical treatment with methotrexate, have all proved to be safe and effective. The remaining principal challenge is to improve future fertility, which is often adversely affected by recurrence of an ectopic pregnancy.

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Multiple-sited (heterotopic) pregnancy after in vitro fertilization and gamete intrafallopian transfer

Cited by 79 publications

References 6 publications

Diagnosis and surgical management of two cases of spontaneous heterotopic pregnancy

Diagnosis and surgical management of two cases of spontaneous heterotopic pregnancy

Spontaneous Heterotopic Pregnancy Associated with Massive Intraperitoneal Haemorrhage and a Normal Heart Rate, Illustrating the Concept of Relative Bradycardia

New Options for Diagnosis and Treatment of Ectopic Pregnancy

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