Abstract
Background: Heterotopic pregnancy is a rare complication of in vitro fertilization (IVF) and diagnosis and treatment can be challenging, particularly with unusual ectopic sites and desire to maintain the intrauterine pregnancy. Case: We review the case of a 29-year-old female who presented with a cornual heterotopic pregnancy following IVF treated with exploratory laparotomy and ultrasound guided resection of the cornual pregnancy, resulting in an ongoing viable singleton intrauterine pregnancy. Conclusion: The management of cornual heterotopic pregnancies is limited by lack of data regarding ideal treatment although several surgical and non-surgical strategies have been described. This case uses abdominal resection of cornual ectopic pregnancy using intraoperative ultrasound as an optimal approach to remove the ectopic pregnancy without disrupting the viable intrauterine pregnancy, which was in close proximity of the cornual ectopic.
Highlights
Heterotopic pregnancy is the coexistence of both an intrauterine and ectopic pregnancy. It is extremely rare occurring in 1 in 30,000 spontaneously conceived pregnancies.[1]. This rate has increased in recent years due to the increase in in vitro fertilization (IVF) pregnancies; it is still rare occurring in about 0.8% of IVF transfers.[1]
We present a case of a heterotopic pregnancy following IVF
This case highlights some of the difficulties in diagnosing and treating a heterotopic pregnancy, when the ectopic pregnancy is in an unusual location
Summary
Cornual heterotopic pregnancy is a rare complication to IVF and patients with vague complaints of pain or bleeding following pregnancy after IVF should be followed closely. The use of intraoperative ultrasound should be considered to guide suture lines during surgical removal of the corneal ectopic pregnancy with the goal of not disrupting the viable intrauterine pregnancy
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