Spontaneous Heterotopic Triplet Pregnancy With Tubal Rupture

Abstract

The recent increase in heterotopic pregnancies has been largely attributed to the increased use of assisted reproduction technologies. We report the rare case of a multiparous woman with a spontaneous conception resulting in a triplet heterotopic pregnancy: a twin intrauterine pregnancy and a single right tubal ectopic pregnancy. Heterotopic pregnancy is a rare and potentially life-threatening condition in which simultaneous gestations occur at 2 or more implantation sites. It is infrequent in natural conception cycles, occurring in 1:30 000 pregnancies. However, the prevalence is rising with the increased use of assisted reproduction techniques to that of 1:100 to 1:500 in these patient subgroups, highlighting the need to incorporate it into a clinician’s diagnostic algorithm.

Study On Diagnosis And Management Strategies On Heterotopic Pregnancy

“…In addition, the widespread aid of ART is associated with a dramatically increased incidence of HP [19]. HP rarely occurs in women without high-risk factors or spontaneous conceptions, other possible risk factors include age ≤35 years, smoking history and use of intrauterine device [20,21]. Thus, we can conclude that the vast majority of patients with HP are women with a history of pelvic surgery or tubal in ammation after ART.…”

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

“…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].…”

“…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].…”

A rare case of triplet heterotopic pregnancy with a live intrauterine and bilateral tubal ectopic

“…Various conservative treatment options like the injection of feticide under ultrasound guidance and expectant management have been reported but, the gold standard is surgery via laparotomy or laparoscopy depending on the clinical scenario. 11 A thorough abdominal and pelvic inspection must be done during surgery for an ectopic gestation, especially on the contralateral side. Frequently, the contralateral pregnancy is discovered a few days to weeks after the initial surgery.…”