Spontaneous heterotopic triplet pregnancy: rare case report

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

“…Heterotopic pregnancy is rare in spontaneous natural pregnancy with the incidence of 1 in 30,000 pregnancies, and het-erotopic triplet pregnancy with ectopic pregnancy coexisting with twin intrauterine pregnancy is rarer [1,3]. Risk factors for heterotopic pregnancy are similar to risk factors for ectopic pregnancy and include previous ectopic pregnancy, pelvic inflammatory disease, infertility, in vitro fertilization, previous tubal reconstructive surgery or pelvic surgery, failed contraceptive methods like intrauterine devices and tubal sterilization, and smoking [4][5][6][7].…”

“…For our case, the identified risk factor was a failed intrauterine device (IUD) as she had conceived on IUD contraception. A high index of suspicion and transvaginal ultrasound are important in timely diagnosis of heterotopic pregnancy especially in spontaneous pregnancies [1]. Early transvaginal ultrasound performed by an experienced sonographer has both high sensitivity and specificity in diagnosing heterotopic pregnancy [8].…”

“…The timing of the diagnosis of heterotopic pregnancy is variable from 5 to 34 weeks with the majority being diagnosed between 5 and 8 weeks of gestation [2]. When the diagnosis is made before rupture of the ectopic pregnancy, the prognosis for the intrauterine pregnancy is good [1]. However, timely diagnosis is only possible where the prenatal ultrasound is available, and women seek for antenatal consultation early in pregnancy.…”

“…It is a rare and potentially life-threatening condition which is infrequent in natural conception cycles with the incidence of 1 in 30,000 pregnancies [1,2]. Its occurrence rises to 1 : 100 to 1 : 500 with the use of assisted reproductive technologies [1,2]. We report a case of spontaneous heterotopic triplet pregnancy with an intrauterine twin pregnancy and ruptured cornual pregnancy diagnosed at 18 weeks of gestation.…”

“…Heterotopic pregnancy is defined as the occurrence of simultaneous intrauterine and extrauterine pregnancy [1]. It is a rare and potentially life-threatening condition which is infrequent in natural conception cycles with the incidence of 1 in 30,000 pregnancies [1,2]. Its occurrence rises to 1 : 100 to 1 : 500 with the use of assisted reproductive technologies [1,2].…”