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Case Report

Successful Surgical Management of a Heterotopic pregnancy

Sheetal B.** , Vijayalakshmi B.* , Sheetal B.** , Shankar J.***

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Indian Journal of Obstetrics and Gynecology 3(1):p 37-39, May-Aug 2015. | DOI: DOI:https://dx.doi.org/10.21088/ijog.2321.1636.3115.7

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Abstract

 Spontaneous heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time .It can be life threatening condition and can be missed easily when the diagnosis being overlooked. Nowadays heterotopic gestation although common with assisted reproductive techniques for subfertility treatment, a high index of suspicion can help in timely diagnosis and appropriate intervention. Heterotopic pregnancy can pose a diagnostic dilemma because an early transvaginal ultrasound may not diagnose an exutero gestation in all cases 1,2 The diagnostic role of serum beta-HCG level in heterotopic pregnancy is debatable. Therefore, if the beta-HCG levels are higher for the period of gestation with an intrauterine pregnancy ,one can look for a co-existant tubal pregnancy. Sometimes there are no conclusive adnexal findings and the diagnosis of ectopic pregnancy may be based on other ultrasound features such as haemoperitoneum ,haematosalphinx and free fluid in peritoneum or pouch of  douglas. We report a case of  heterotopic pregnancy in a 23  year old woman presented with  haemoperitoneum from ruptured tubal pregnancy with live intrauterine gestation of 7 weeks ,diagnosed on  transvaginal ultrasound.  

Keywords : Heterotopic pregnancy,spontaneous conception, adnexal mass,  haemoperitoneum. 

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DOI: DOI:https://dx.doi.org/10.21088/ijog.2321.1636.3115.7

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