Abstract
Heterotopic pregnancy (HP) is a rare form of multiple pregnancy where a combined intrauterine gestation develops simultaneously with an extrauterine pregnancy. The majority of extrauterine implantations are tubal. Other uncommon sites can include ovaries, cervix and the abdomen.
Highlights
Heterotopic pregnancy (HP) is a rare form of multiple pregnancy where a combined intrauterine gestation develops simultaneously with an extrauterine pregnancy
There have been documented cases of higher order multiple heterotopic gestations; spontaneous triplet HP with two sacs seen in one tube [3] and in another case an ectopic pregnancy in each tube with a single intrauterine gestation
In 1948, 1 in 30,000 gravidas presented with HP [6]; recent studies report 1 in 3,800 [7]
Summary
Heterotopic pregnancy (HP) is a rare form of multiple pregnancy where a combined intrauterine gestation develops simultaneously with an extrauterine pregnancy. CC can hyperstimulate the ovaries leading to the release of multiple mature follicles This results in a 5-10% risk of multiple pregnancy, with majority being twins, higher order multiple pregnancies have been reported [10]. A 34 year old primigravida with a 3 year history of unexplained primary infertility had induction of ovulation with clomiphene citrate in our centre She conceived after two cycles of treatment. She presented in our Early Pregnancy Assessment Unit at 7 weeks gestation with mild vaginal bleeding and lower abdominal pain. Serial ultrasound examinations showed a normal developing foetus She spontaneously laboured at 41+2 weeks and was delivered by forceps for a delayed second stage of labour. Her male baby weighed 3500 g and had an Apgar score of 8 and 9, at 1 and 5 minutes respectively
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