Simultaneous cornual heterotopic and intrauterine pregnancy following in vitro fertilization/embryo transfer: new conservative surgery with laparoscopic lesion resection

B Luo,L Luo

doi:10.12891/ceog4667.2019

Abstract

Objective: To report a case of simultaneous heterotopic cornual and intrauterine pregnancy managed with laparosopic lesion resection. Results: A 37-year-old woman with heterotopic cornual and intrauterine pregnancy after assisted reproductive technologies (ART) was treated with laparosopic lesion resection. Finally the integrity of uterus was maintained and the patient delivered at term by cesarean section. Conclusion: This is the first report on managing heterotopic cornual and intrauterine pregnancy by lesion resection with laparoscopy. This minimally new conservative surgery can be consider in the management of heterotopic cornual pregnancy.

Highlights

As the elevated tendency of assisted reproductive technologies (ART), the occurrence of heterotopic pregnancy (HP) has been increasing gradually in recent years
We identified an intact intrauterine gestational sac at 3.8×3.8×3.9cm, and fetal heart beat was obvious
Simultaneous cornual pregnancy and intrauterine pregnancy are believed to occur in 1% of all HPs [2]

Summary

Introduction

As the elevated tendency of assisted reproductive technologies (ART), the occurrence of heterotopic pregnancy (HP) has been increasing gradually in recent years. The result of blood hCG on 14th day after embryo transfer (ET) was 524.54 mIU/ml and a pregnancy was confirmed. Her prior history included laparoscopic surgery for bilateral fallopian tube obstruction one year ago. In this hospital, the resultd of blood E2, P, and hCG were 1,193.3 pg/ml, 28.6 2 ng/ml, and > 200,000.0 mIU/ml, respectively. Laparoscopic surgery showed a slightly convex, soft and thin wall of the left uterine cornu which next to the 8 weeks gestation of uterus (Figures 1 and 2). 1-0 vicryl sutures were sutured circumferentially about the left uterine cornual pregnancy (Figures 4 and 5). A female infant was delivered by cesarean at 39 weeks

Discussion

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Conclusion