The rising incidence of heterotopic pregnancy: Current perspectives and associations with in-vitro fertilization

Maleki, Aryan; Khalid, Noorulain; Patel, C. C.; Elmahdi, Essam

doi:10.1016/j.ejogrb.2021.09.031

Cited by 35 publications

(37 citation statements)

References 70 publications

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“…Spontaneous HP is rare, with an estimated incidence of 1/30 000 pregnancies. 1 In the setting of IVF with embryo transfer procedures, some authors suggested that this incidence could be higher, with…”

Section: Descriptionmentioning

confidence: 99%

“…tubal abnormalities and the number of embryos transferred being the most important risk factors. [1][2][3] Considering the widespread use of assisted reproduction technologies is mandatory to maintain a high level of suspicion and awareness about the specific sonographic criteria of HP, which represents the diagnostic modality of choice. 2 Figure 1 represents an HP with tubal ectopic pregnancy and clearly demonstrates an intrauterine gestational sac and an extrauterine gestational sac.…”

Section: Images In…mentioning

confidence: 99%

“…Spontaneous HP is rare, with an estimated incidence of 1/30 000 pregnancies 1. In the setting of IVF with embryo transfer procedures, some authors suggested that this incidence could be higher, with tubal abnormalities and the number of embryos transferred being the most important risk factors 1–3…”

Section: Descriptionmentioning

confidence: 99%

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Tubal heterotopic pregnancy: challenges when infertility is present

et al. 2023

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Section: Descriptionmentioning

confidence: 99%

Section: Images In…mentioning

confidence: 99%

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Tubal heterotopic pregnancy: challenges when infertility is present

et al. 2023

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“…The risk of having a heterotopic pregnancy from natural conception is estimated to be from 1 in 4,000 to 1 in 30,000 [ 1 ]. With the emergence of assisted reproductive technology, the incidence has been reported to be as high as 1 in 100 [ 1 , 2 ]. Despite its rarity, the presence of a confirmed IUP should not exclude a concurrent extrauterine pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Heterotopic Pregnancy: Diagnosis and Management

Nguyen

Hudspeth

Milestone

2022

Case Reports in Obstetrics and Gynecology

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Background. Heterotopic pregnancies albeit rare are conceivably life-threatening if missed. With the development of assisted reproductive techniques, the incidence has increased. Confirmation of an intrauterine pregnancy (IUP) should not preclude the existence of a heterotopic pregnancy. Case. A healthy 27-year-old patient (gravida 4, term 1, preterm 0, abortion 2, living 1) at approximately 5 weeks gestation through natural conception presented to the emergency room with acute abdominal pain and vaginal bleeding. Pelvic ultrasound showed evidence of an IUP and a right adnexal mass, raising suspicion for a heterotopic pregnancy. The patient underwent an uncomplicated laparoscopic right salpingectomy. An IUP was confirmed on ultrasound postoperatively. The patient had an early pregnancy loss at 8 weeks of gestation. Conclusion. With a high index of suspicion from clinical presentation and pelvic imaging, heterotopic pregnancy, while rare, should not be ruled out.

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“…The dramatic rise in cesarean deliveries accounting for 31.7% of all US deliveries in 2019 has led to an increased incidence of implantation in the myometrial scar, 2 accounting for up to 6.1% of all EPs in women with at least one prior cesarean section 3 . Widespread use of assisted reproductive techniques has caused an increasing number of heterotopic pregnancies with an estimated incidence of 1 in 100 in vitro fertilization recipients 4 . All of these factors make the US appearance of EP more variable and more prone to misdiagnosis.…”

Section: Introductionmentioning

confidence: 99%

The Confounding Ultrasound Diagnosis of Ectopic Pregnancy: Lessons From Peer Learning

Yun

Horrow

Goykhman

et al. 2022

Ultrasound Quarterly

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As the treatment of ectopic pregnancy (EP) has shifted increasingly to medical therapies, the ultrasound (US) diagnosis of EP must necessarily favor specificity over sensitivity. Our review of peer learning cases of EP and early intrauterine pregnancies found several types of pitfalls and problems, which will be described in this essay. These issues include the following: differentiation of tubal EP from a corpus luteum by echogenicity relative to ovarian parenchyma, push technique, and claw sign; how to distinguish interstitial EP from eccentrically located intrauterine pregnancies (angular); use of trophoblastic flow in abnormal intrauterine locations to help identify cesarean scar or cervical implantations; recognition that hemoperitoneum without visualized EP may be due to EP or hemorrhagic cyst; and that distinguishing an abortion in progress from a pregnancy of unknown location may not always be possible and requires clinical follow-up. This essay will also illustrate the consensus terminology that our radiology department has developed in conjunction with our obstetrics and gynecology colleagues to communicate clear diagnoses and reduce the risk of misdiagnosis and adverse outcomes.

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The rising incidence of heterotopic pregnancy: Current perspectives and associations with in-vitro fertilization

Cited by 35 publications

References 70 publications

Tubal heterotopic pregnancy: challenges when infertility is present

Tubal heterotopic pregnancy: challenges when infertility is present

Spontaneous Heterotopic Pregnancy: Diagnosis and Management

The Confounding Ultrasound Diagnosis of Ectopic Pregnancy: Lessons From Peer Learning

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