Laparoscopic Management of a Spontaneous Interstitial Heterotopic Pregnancy with Preservation of the Intrauterine Pregnancy: Case Report from Middle East

Ahmad Talal Chamsi,Ashraf Dawood

doi:10.21767/2471-8165.1000064

Abstract

Heterotopic pregnancy is defined as multiple gestation in which one gestational sac is intrauterine while the other is extra uterine- most commonly tubal ectopic pregnancy. An interstitial ectopic pregnancy is one of the most lifethreatening types of ectopic gestations, with a mortality rate that can reach 6-7 times higher than that of the ectopic pregnancies in general. In our case report, heterotopic pregnancy occurs after a spontaneous conception cycle. A 34-year-old Gravid 3 Para 1 + Abortion 1 woman with a gestational age of 8 weeks + 3 days by LMP. She was diagnosed and managed laparoscopicaly by right salpingectomy with preservation of intrauterine pregnancy. She was discharged on the second postoperative day and followed-up regularly at the obstetrics clinic with uneventful antenatal follow up. This might be the first case to be presented from Middle east with such scenario. Careful evaluation of the adnexa is mandatory not only in women undergoing assisted reproduction, but also with spontaneous pregnancy to avoid delayed diagnosis in such cases.

Highlights

Heterotopic pregnancy is defined as multiple gestation in which one gestational sac is intrauterine while the other is extra uterine- most commonly tubal ectopic pregnancy
We hereby present a case of intestinal heterotopic pregnancy that occurred after a spontaneous conception cycle
She is married for 9 years with a previous Cesarean delivery due to fetal distress 7 years back followed by one first trimester spontaneous miscarriage

Summary

Introduction

Heterotopic pregnancy is defined as multiple gestation in which one gestational sac is intrauterine while the other is extra uterine- most commonly tubal ectopic pregnancy. We hereby present a case of intestinal heterotopic pregnancy that occurred after a spontaneous conception cycle. Pain was not relieved by analgesics and associated with dizziness Regarding obstetrical history, she is married for 9 years with a previous Cesarean delivery due to fetal distress 7 years back followed by one first trimester spontaneous miscarriage. She is married for 9 years with a previous Cesarean delivery due to fetal distress 7 years back followed by one first trimester spontaneous miscarriage Operative finding revealed a ruptured ectopic pregnancy and the interstitial part of the right fallopian tube with Haemoperitoneum of 800 ml reaching the peri-hepatic region (Figure 2). A transvaginal ultrasound scan done postoperative day 1 revealed a viable intrauterine pregnancy going with date

Discussion

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Conclusion

Ethical Approval