Tube-Abdominal Heterotopic Pregnancy

Abstract

Heterotopic pregnancy is a rare multiple pregnancy where an intrauterine pregnancy coexists with an ectopic pregnancy. The incidence of heterotopic pregnancy is 1 in 10,000 to 50,000 spontaneous pregnancies. The increase of assisted reproductive techniques has increased the incidence of heterotopic pregnancy, up to 1 % of the pregnancies achieved by these techniques. The objective of this study is to present the case of a patient with a heterotopic pregnancy that is rare. We present a 32-year-old female patient, primiparous, with a history of health. She came to consultation due to 10.2-week amenorrhea, low pain with intensification and genital persistent dark bleeding. The physical examination shows an enlarged uterus that coincides with amenorrhea and the plump and painful the bottom of Douglas sac. Ultrasonography was conclusive in the diagnosis of heterotopic pregnancy. A laparotomy and total left salpingectomy and excision of the placenta were performed. The immediate postoperative was satisfactory. The ultrasound performed three weeks later showed the existence of an intrauterine alive embryo of approximately 12 weeks. The patient was followed in consultation with obstetrics and she had a eutocic delivery at 36.2 weeks with alive newborn, in good condition and underweight.