Successful heterotopic pregnancy with prior radical trachelectomy after transabdominal cervico isthimic cerclage with methotrexate treatment

Lee, Kyong-No; Ham, Hye Seon; Whang, Eun-Jee; Eun-Ji, Jo; Choi, Seung-Hye; Lee, Keun-Young

doi:10.1111/jog.14196

Cited by 2 publications

(4 citation statements)

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“…High-risk factors for heterotopic pregnancy (HP) include a history of unilateral or bilateral salpingectomy [ 11 , 13 , 16 , 18 , 23 , 24 , 28 , 29 , 30 ], EP [ 11 , 16 , 18 , 24 , 28 , 29 ], ovulation induction, and IVF-ET [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 18 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Particularly, IVF-ET increases the occurrence of IP [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…The successful delivery rate of IUP after interventional ultrasound can reach 100% [ 6 ]. Available drugs are KCl [ 7 , 8 , 14 , 21 ] MTX [ 15 , 18 , 29 ] and hypertonic glucose [ 20 ]. Since the first report of the successful treatment of HIP by the ultrasound-guided injection of KCl in 1992 [ 7 ], many medical centers have carried out studies, all of which have achieved good results.…”

Section: Discussionmentioning

confidence: 99%

“…To date, conservative treatment with multiple doses and/or topical MTX has become the standard of care for IP; however, systemic MTX is contraindicated in the presence of IUP [ 6 , 51 , 52 ] because high doses of MTX may cause fetal congenital bone deformity or IUP miscarriage [ 53 ]. Nevertheless, low-dose MTX treatment has been shown to have no effect on coexisting IUP [ 29 ]. The ultrasound-guided local injection of 25 mg MTX has been reported to terminate IPs without affecting IUPs [ 54 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

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Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Tan

Chen

et al. 2023

JPM

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Purpose: This study aims to share the experience of minimally invasive ultrasound-guided methotrexate intervention in the treatment of heterotopic interstitial pregnancy (HIP) with good pregnancy outcomes, and to review the treatment, pregnancy outcomes, and impact on the future fertility of HIP patients. Methods: The paper describes the medical history, clinical manifestations, treatment history, and clinical prognosis of a 31-year-old woman with HIP, and reviews cases of HIP from 1992 to 2021 published in the PubMed database. Results: The patient was diagnosed with HIP by transvaginal ultrasound (TVUS) at 8 weeks after assisted reproductive technology. The interstitial gestational sac was inactivated by ultrasound-guided methotrexate injection. The intrauterine pregnancy was successfully delivered at 38 weeks of gestation. Twenty-five HIP cases in 24 studies published on PubMed from 1992 to 2021 were reviewed. Combined with our case, there were 26 cases in total. According to these studies, 84.6% (22/26) of these cases were conceived by in vitro fertilization embryo transfer, 57.7% (15/26) had tubal disorders, and 23.1% (6/26) had a history of ectopic pregnancy; 53.8% (14/26) of the patients presented with abdominal pain and 19.2% (5/26) had vaginal bleeding. All cases were confirmed by TVUS. In total, 76.9% (20/26) of intrauterine pregnancies had a good prognosis (surgery vs. ultrasound interventional therapy 1:1). All fetuses were born without abnormalities. Conclusions: The diagnosis and treatment of HIP remain challenging. Diagnosis mainly relies on TVUS. Interventional ultrasound therapy and surgery are equally safe and effective. Early treatment of concomitant heterotopic pregnancy is associated with high survival of the intrauterine pregnancy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Tan

Chen

et al. 2023

JPM

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“…Although the phenomenon is rare, it occurs more frequently nowadays and may be associated with lifethreatening complications such as ruptured uterus and massive bleeding. Previous tubal surgeries and pelvic inflammatory diseases increase the risk of this anomaly (2). Surgery may successfully save most of these types of pregnancies and therefore embryos if the condition is diagnosed early.…”

Section: Introductionmentioning

confidence: 99%

Heterotopic Pregnancy After In Vitro Fertilization Ending with a Successful Term Labor, a Case Report

Livani

Fatemi

2021

Gene Cell Tissue

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Introduction: Heterotopic pregnancy is defined as the simultaneous presence of intrauterine and ectopic pregnancies, manifesting with abdominal pain and vaginal bleeding. Previous tubal surgeries and pelvic inflammatory diseases increase the risk of this anomaly. In this case report, heterotopic pregnancy after in vitro fertilization (IVF) in an 18-year-old female was reported. Case Presentation: An 18-year-old female was referred to our medical center, presenting with abdominal pain and vaginal bleeding. She had IVF pregnancy seven weeks ago without a history of any other illness or consuming a specific drug. According to ultrasound results, heterotopic pregnancy was diagnosed. Therefore, we decided to perform the salpingectomy and laparotomy of the fetus. The patient had a normal delivery via cesarean section at term (the 38th week of pregnancy). The patient remained stable without any further referral for the mentioned condition. Conclusions: Due to the importance of heterotopic pregnancy and its prevalence among women using fertility procedures and assisted reproduction techniques (such as IVF), even in the presence of a gestational sac containing yolk sac and after the detection of the embryo in the endometrium cavity, the adnexa should be well checked to rule out heterotopic pregnancy to obviate the risk of abortion and other fatal outcomes.

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Successful heterotopic pregnancy with prior radical trachelectomy after transabdominal cervico isthimic cerclage with methotrexate treatment

Cited by 2 publications

References 8 publications

Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Successful Ultrasound-Guided Methotrexate Intervention in the Treatment of Heterotopic Interstitial Pregnancy: A Case Report and Literature Review

Heterotopic Pregnancy After In Vitro Fertilization Ending with a Successful Term Labor, a Case Report

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