Second Trimester Heterotopic Triplet Pregnancy with Intrauterine Twin Pregnancy and Ruptured Interstitial Pregnancy: A Maternal Near-Miss Case Report

Abstract

Heterotopic pregnancy is defined as the occurrence of simultaneous intrauterine and extrauterine pregnancies. It is a rare, potentially life-threatening condition and infrequent in natural conceptions. Here, we report a case of spontaneous heterotopic triplet pregnancy with ruptured cornual ectopic pregnancy and simultaneous twin intrauterine pregnancies at 18 weeks of gestation. The event led to miscarriage of all fetuses from both the ectopic and the intrauterine twin pregnancies.

Spontaneous Heterotopic Cesarean Scar Triplet Gestation Following Uterine Ablation

“…The patient underwent gravid hysterectomy and evacuation of 4 L of hemoperitoneum and survived. 6 Heterotopic pregnancy most commonly refers to one tubal pregnancy and one intrauterine pregnancy. However, heterotopic cesarean scar pregnancies have been reported mostly in the context of in vitro fertilization (IVF) with embryo transfer.…”

“…Heterotopic triplet pregnancies have been reported in case reports. [1][2][3][4][5][6] Cesarean scar ectopic is a rare event with no currently reported rates, but this condition is becoming more common as women undergo more cesarean sections. 7 Those who continue cesarean scar pregnancies are at high risk of morbidity such as placenta accreta spectrum (PAS), cesarean scar dehiscence/uterine rupture, postpartum hemorrhage, and postpartum hysterectomy.…”

Live birth by cesarean section after rupture of uterine cornua in simultaneous corneal and intrauterine pregnancies

“…(Table 1). 7–12 This case was after suturing the cornual incision, as mentioned in other literature, and we chose a selective cesarean section, paying attention to the risk of uterine rupture. There is also a literature that suggests the importance of myometrium measurement regarding the risk of rupture in cases of cornual incision 13 .…”

Distinguishing between cornual, angular and interstitial ectopic pregnancy: A case report and a brief literature review

“… [58] 2014 1 Not reported Not reported 15 wk Fetal demise Nkurunziza et al. [59] 2020 3 Not reported Not reported 18 wk Right interstitial pregnancy plus 2 intrauterine fetal demises; subtotal hysterectomy Ahlschlager et al. [19] 2021 1 Not reported Not reported 15 wk 3 d Left interstitial pregnancy Scarella et al.…”