Cornual Heterotopic Pregnancy Research Articles

The risk factors for miscarriage of viable intrauterine pregnancies in patients with heterotopic pregnancy after surgical intervention.

To summarize the clinical characteristics and explore the risk factors for miscarriage of a viable intrauterine pregnancy following surgical intervention in patients with heterotopic pregnancy (HP). A total of 106 women diagnosed with HP that underwent surgical intervention in the Women's Hospital School of Medicine Zhejiang University between January 2014 and December 2021 were included in this retrospective study. They were divided into a miscarriage group (n = 13) and an ongoing pregnancy group (n = 93) according to the outcomes of the HP within 2 weeks after surgery. Data regarding clinical characteristics, surgical conditions, postoperative recovery, and complications were collected and compared between the groups. Logistic multivariate analysis was performed to explore the risk factors for miscarriage in patients with HP within 2 weeks of surgical intervention. Among the 106 women with HP, 80 had tubal HP, 8 had cornual HP, and 18 had interstitial HP. Eighty-seven (82.1%) patients developed clinical symptoms that manifested primarily as abnormal vaginal bleeding and/or abdominal pain, whereas 19 (17.9%) patients had no clinical symptoms. The mean gestational age on the day of surgery was 7.2 weeks (inter-quartile range, 6.4-8.3). The miscarriage rate within 2 weeks of surgical intervention was 12.3% in patients with HP. Compared to the ongoing pregnancy group, the miscarriage group had a higher body mass index, earlier gestational age at treatment, and higher volume of hemoperitoneum (P < .05 for all). Logistic multivariate analysis indicated that the women with a hemoperitoneum volume > 200 mL had significantly higher risk of miscarriage after adjusting covariates [OR (odds ratio) = 5.285, 95% CI (confidence interval) (1.152-24.238), P < .05]. Hemoperitoneum volume was independently associated with miscarriage of viable intrauterine pregnancies in patients with HP within 2 weeks of surgical intervention.

Management of Spontaneous Cornual Heterotopic Pregnancy in Low-Resources Setting

Objective: To report management of spontaneous cornualheterotopic pregnancy in low-resources setting in EndeDistrict, Flores, East Nusa Tenggara.Methods: Case report.Case: A 34 year old primigravida with history of 8-9 weeksamenorrhea came to Obstetrics ER with chief complaintof vaginal bleeding and lower abdominal pain. Ultrasoundshows intrauterine pregnancy (IUP), an ectopic pregnancy(EP) in right uterine cornu, and free fl uid in hepatorenalspace, splenorenal space, and pouch of douglas suggestingthe occurrence of hemoperitoneum and heterotopicpregnancy. We performed cornual resection by laparotomyand administered progesterone orally before and after thesurgery. Successful outcome was achieved.Discussion: Heterotopic pregnancy (HP) rarely occurs,especially in natural conception. Thus, early diagnosis andtreatment of HP are quite a challenge for physicians especiallyin rural area. Due to the condition of our patient and limitedresources, laparotomy was conducted to remove the EP,rather than laparoscopy despite its advantage to lower riskof IUP abortion. Progesterone was then administered orallyto prevent threatened abortion of the IUP.Conclusion: Despite its challenge in diagnosing andtreating HP, it is a life-threatening condition that requiresaccurate and prompt treatment. The treatment goal is toremove the EP and preserve the IUP. Treatment of choiceshould be decided by takeing the patient’s condition andavailability of resources into account. Surgical along withadministration of progesterone before and after the surgerywould likely improve the outcome of the patient and theintrauterine pregnancy.Keywords: cornual resection, heterotopic pregnancy,laparotomy, low-resources setting, progesterone.AbstrakTujuan: Untuk membahas tentang penatalaksanaankehamilan heterotopik kornu spontan di daerah dengansumber daya rendah khususnya di Kabupaten Ende, Flores,Nusa Tenggara Timur.Metode: Laporan KasusKasus: Seorang perempuan primigravida usia 34 tahundengan riwayat amenore minggu ke-8 dan 9 datang keIGD Obgyn dengan perdarahan pervaginam dan nyeriperut bagian bawah. Temuan USG menunjukkan kehamilanintrauterin (KIU), kehamilan ektopik (KE) di tanduk rahimkanan, dan cairan bebas di ruang hepato-renal, splenorenal,dan cavum douglas. Hal ini menunjukkan terjadinyahemoperitoneum dan kehamilan heterotopik. Reseksikornu dengan laparotomi dilakukan dan pasien diberikanprogesteron secara oral sebelum dan setelah operasi.Luaran baik berhasil dicapai.Diskusi: Kehamilan heterotopik jarang terjadi, terutamapada konsepsi alami. Sehingga diagnosis dan tata laksanaKH sejak dini menjadi tantangan bagi para dokter, terutamadi daerah terpencil Karena kondisi pasien dan sumber daya,laparotomi dilakukan untuk mengangkat KE, daripadalaparoskopi meskipun keuntungannya dalam menurunkanrisiko keguguran KIU. Progesteron kemudian diberikansecara oral untuk mencegah terjadinya keguguran terancamdari KIU.Kesimpulan: Terlepas dari tantangan untuk diagnosisdan tatalaksananya, KH adalah kondisi yang mengancamjiwa yang membutuhkan penanganan yang akurat dansegera. Tujuan tatalaksananya adalah untuk mengangkatKE dan mempertahankan KIU. Pilihan tata laksana harusdiputuskan dengan mempertimbangkan kondisi pasien danketersediaan sumber daya. Pendekatan bedah dan obatdengan progesteron yang diberikan sebelum dan sesudahoperasi akan meningkatkan kemungkinan luaran pasien dankehamilan intrauterine yang baik.Kata kunci: kehamilan, heterotopik, laparotomi,progesteron,reseksi kornual, sumber daya rendah.

Expanding Horizons: Laparoscopic Management of Unruptured Cornual Heterotopic Pregnancy Safeguarding Intrauterine Pregnancy

<h3>Study Objective</h3> Feasibility of Minimally invasive surgery to handle extremely rare conditions of heterotopic cornual ectopic pregnancy. <h3>Design</h3> Compilation of videos consisting of four surgical procedures over six years performed on a patient with specific focus on heterotopic cornual ectopic pregnancy managed laparoscopically. <h3>Setting</h3> Operative laparoscopy for cornual ectopic pregnancy was performed under general anaesthesia in semi lithotomy position. Optical 11 mm trocar was introduced from umbilicus and other three ancillary 6 mm ports were used. C section of same patient at full term was carried out under regional anaesthesia with Pfannenstiel incision. <h3>Patients or Participants</h3> The patient had undergone laparoscopic bilateral neosalpingostomy as a part of fertility restoration surgery which was followed by bilateral salpingectomy for recurrent hydrosalpinx and tubal ectopic pregnancy. Following which patient underwent Assisted reproductive technique but unfortunately developed rare form of multiple gestation (heterotopic pregnancy with one left cornual ectopic component and second healthy intrauterine pregnancy). It was diagnosed in time and treated with operative laparoscopy. The intrauterine pregnancy continued till term and a healthy singleton child was delivered by C section at 37th week. <h3>Interventions</h3> I was prudent to avoid prolonged use of general anaesthesia and to reduce use of electrocautery on gravid uterus. For achieving effective hemostasis four stay sutures with delayed absorbable suture material was taken on both sides and base of ectopic gestation which was very vascular lesion due to gravid uterus. <h3>Measurements and Main Results</h3> With minimal use of electrocautery and without using vasoconstrictors or uterine artery ligation, extremely vascular cornual ectopic pregnancy was safely removed by operative laparoscopy. Myometrial defect was properly reconstructed with delayed absorbable sutures, without causing any short term or long-term harm to ongoing precious intrauterine pregnancy. <h3>Conclusion</h3> Extremely rare and complex situation of heterotopic cornual ectopic pregnancy can be very safely managed with proper application of principles of minimal invasive surgery safeguarding the intrauterine pregnancy.

Resection of a Cornual Heterotopic Pregnancy Using Single-Site Laparoscopic Techniques

<h3>Study Objective</h3> To describe techniques for resection of a cornual heterotopic pregnancy. <h3>Design</h3> Demonstration of surgical technique with narrative video footage using two case examples. <h3>Setting</h3> Academic medical center. <h3>Patients or Participants</h3> A case of an 8-week cornual heterotopic pregnancy with successful delivery of the intrauterine pregnancy and a case of a cornual ectopic at 10 weeks. <h3>Interventions</h3> We demonstrate the use of a "purse string" technique using robotic assisted single incision laparoscopy to resect a cornual heterotopic with minimal blood loss using a 2-0 V-lock suture. Additionally, we review this similar technique with traditional single-site laparoscopic surgery. <h3>Measurements and Main Results</h3> Resection of a cornual heterotopic pregnancy can be successful done using a "purse string" technique. This technique allows for minimal blood loss as well as minimal entry into the myometrium, which allows for minimal manipulation of the concurrent intrauterine pregnancy. <h3>Conclusion</h3> Resection of cornual heterotopic pregnancy can be done using a "purse-string" surgical technique. This technique allows for minimal blood loss in cases where additional techniques for hemostasis cannot be used, such as injection of vasopressin and uterine artery ligation. We also demonstrate that this technique can be successful completed using either traditional or robotic assisted single incision laparoscopic surgery.

Management of 14 patients with cornual heterotopic pregnancy following embryo transfer: experience from the past decade

ObjectiveThere are two major management approach for cornual heterotopic pregnancy, transvaginal cornual embryo reduction with ultrasound guidance, or laparoscopic cornual resection. This no consensus on the optimal management for cornual heterotopic pregnancy. Here, we are trying to determine the optimal management approach for patients with viable cornual heterotopic pregnancy following embryo transfer.MethodsThis is a retrospective cohort study conducted at the locally largest reproductive center of a tertiary hospital. A total of 14 women diagnosed as viable cornual heterotopic pregnancy following embryo transfer. Six patients were treated with cornual pregnancy reduction under transvaginal ultrasound guidance without the use of feticide drug (treatment 1), and eight patients were treated with laparoscopic cornual pregnancy resection (treatment 2).ResultsAll 14 patients of cornual heterotopic pregnancy following embryo transfer due to fallopian tubal factor, among which, 12 patients had cornual pregnancy occurred in the ipsilateral uterine horn of tubal pathological conditions. Nine (64.29%) showed a history of ectopic pregnancy. Thirteen (92.86%) patients were transferred with two embryos and only one patient had single embryo transferred. Six patients received treatment 1, and 2 (33.33%) had uterine horn rupture and massive bleeding which required emergency laparoscopic surgery for homostasis. No cornual rupture occurred among patients received treatment 2. Each treatment group had one case of spontaneous miscarriage. The remaining 5 cases in treatment 1 group and the remaining 7 cases in treatment 2 group delivered healthy live offspring.ConclusionPatients with tubal factors attempting for embryo transfer, especially those aiming for multiple embryos transfer, should be informed with risk of cornual heterotopic pregnancy and the subsequent cornual rupture. Compared with cornual pregnancy reduction under transvaginal ultrasound guidance, laparoscopic cornual resection might be a favorable approach for patients with viable cornual heterotopic pregnancy.

Minimally invasive surgical management of a cornual ectopic pregnancy, with and without a concurrent intrauterine pregnancy

To describe techniques for resection of a cornual heterotopic pregnancy. This video demonstrates a surgical technique for excision of a cornual heterotopic pregnancy with narrative video footage using two case examples. The incidence of cornual heterotopic pregnancy is unknown; however, the incidence of heterotopic pregnancy itself has increased through the use of assisted reproductive technologies and the majority of cornual heterotopic pregnancies occur after assisted reproductive technologies use. These cases have been treated traditionally using exploratory laparotomy and cornual wedge resection with good outcomes. With advancements in minimally-invasive surgical techniques, laparoscopic resection of cornual heterotopic pregnancies has been demonstrated to be safe and feasible. A patient with an 8-week cornual heterotopic pregnancy and a patient with a 10-week cornual ectopic pregnancy. Laparoscopic resection of the cornual ectopic pregnancy. Feasibility of a "purse-string" technique for the resection of a heterotopic cornual pregnancy. Robotic-assisted laparoscopic resection of a cornual heterotopic pregnancy can be performed with minimal blood loss with the use of the "purse-string" technique in settings where vasopressin cannot be used for hemostasis. This technique includes the use of a 2-0 V-Loc suture in a circumferential fashion around the ectopic pregnancy, which allows for faster suturing and immediate tension at the myometrium. The same suture is then used to close the defect, which allows for a simpler and efficient closure with minimal entry into the myometrium. In this video, we demonstrate the successful resection of cornual heterotopic pregnancy using a "purse-string" surgical technique. This technique allows for minimal blood loss in cases where additional techniques for hemostasis cannot be used, such as injection of vasopressin and uterine artery ligation.

A pitfall in ultrasonographic diagnosis–heterotopic cornual pregnancy initially misdiagnosed as leiomyoma

A pitfall in ultrasonographic diagnosis–heterotopic cornual pregnancy initially misdiagnosed as leiomyoma

1450 Laparoscopic Cornual Resection of Heterotopic Cornual Pregnancy

Video Objective Laparoscopic heterotopic cornual pregnancy resection. Setting A 41 y/o woman, with history of G3P0E1(status post right salpingectomy)SA1 got pregnancy via IVF with frozen embryo transferred. Four embryos were transferred. However, at about gestational age 6 weeks, two intrauterine gestational sac and one right cornual gestational sac were found. All the fetus had heart beats. Thin uterine wall at right cornus about 0.53cm in size was also noticed. To preserve normal intrauterine pregnancy, surgical intervention was suggested, and the patient received laparoscopic cornual resection surgery. Interventions During operation, to prevent fetus injury, we didn't use uterine manipulator or pitressin injection. We also avoided electrical energy device to decrease thermal effect to fetus. Because of the rich blood flow of uterus, we hoped to decreased the surgical time, and barbed suture was used. Multiple suture layers for uterus was applied. We also used vaginal ultrasound during operation to check the uterine condition. After checking bleeders, adhesion barrier was used. For postoperative medication, progesterone was prescribed for tocolysis. We checked ultrasound after the surgery, and only one fetus with fetal heart beat was noticed. Conclusion Laparoscopic heterotypic cornual pregnancy resection is feasible with the advantages of decreased hospital stay, less wound pain, and less use of analgesics. Further obstetrics outcome is reassuring in current studies.

2363 Laparoscopic Management of Heterotopic Cornual Pregnancy - Tips & Tricks

Video Objective To provide practical tips and tricks on laparoscopic management of a heterotopic cornual pregnancy. Setting This video presents a 38-year-old nulliparous female patient who received bilateral salpingectomy and then underwent in vitro fertilization. Heterotopic pregnancy was found at 8 weeks of gestation. We arranged fetal reduction by ultrasound-guided potassium chloride injection. Two weeks after the procedure, severe lower abdominal pain developed. Due to massive hemoperitoneum with suspected left cornual rupture, she was admitted for laparoscopic intervention. Interventions Laparoscopic surgery was arranged. Left cornual pregnancy with necrosis and oozing were seen upon entry into the abdominal cavity. Estimated internal bleeding was about 3000 ml. Laparoscopic management was carried out in five steps: identification of the cornual protruding mass; control of bleeding via a loop ligation; incision of the cornus precisely with complete removal of the ectopic gestational tissue; closure of the defect of the cornus; and hemostasis using Floseal matrix. Conclusion The surgery was done smoothly and the patient recovered well with ongoing pregnancy. However, the patient underwent termination of pregnancy at 23 weeks of gestation due to fetal hydrocephalus.

Reply letter to: “Comments on manuscript: Laparoscopic treatment of cornual heterotopic pregnancy: A retrospective cohort study”

Reply letter to: “Comments on manuscript: Laparoscopic treatment of cornual heterotopic pregnancy: A retrospective cohort study”

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

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.

Cornual heterotopic pregnancy after in vitro fertilization: management by laparoscopic repair

The incidence of heterotopic pregnancy has risen dramatically with the widespread use of assisted reproductive technology. The risk factors for this pathology include tubal infertility, cleavage stage embryo transfer and frozen embryo transfer. Herein we report two cases with cornual heterotopic pregnancy after in vitro fertilization/embryo transfer. They managed by laparoscopic cornual repair or salpingectomy. Early diagnosis and appropriate management of heterotopic pregnancy may lead to a favorable prognosis.

Successfully Managing Cornual Heterotopic Pregnancy: A Case Report and Literature Review

Cornual heterotopic pregnancy is an extremely rare, life-threatening complication during pregnancy. Here, we report a 33-year-old woman who suffered cornual heterotopic pregnancy after in vitro fertilization embryo transfer. To prevent rupture during heterotopic pregnancy, she received laparoscopic surgery to remove the ectopic gestational sac at 7+2 weeks of gestation. Ultimately, she delivered a healthy boy at 38+3 weeks of gestation. Here, we also review the clinical presentations, risk factors, treatment options and outcomes of cornual heterotopic pregnancy.

Laparoscopic treatment of cornual heterotopic pregnancy: A retrospective cohort study

ObjectiveTo report on our experience of laparoscopic cornuostomy or cornual repair for cornual heterotopic pregnancy. Study designA single center, retrospective review of patients who were diagnosed as cornual heterotopic pregnancy, which developed after in vitro fertilization and embryo transfer (IVF/ET) between January 2009 and June 2014. All patients were managed by laparoscopic cornuostomy or cornual repair. Results14 patients were enrolled and 4 patients were finally confirmed to have a ruptured cornu. 4/4 presented as acute abdominal pain and 3/4 as metrorrhagia. The blood pressure of all the patients were stable. The earliest ruptured patient of this series happened at 23 days after IVF/ET. The hemoglobin levels of the 4 ruptured patients were significantly lower than the other patients (8.6 ± 1.8 g/dl versus 12.2 ± 1.1 g/dl, p < 0.001). Internal bleeding before operation was significantly higher in the ruptured patients than in the intact patients (1050.0 ± 369.8 ml versus 0.0 ± 0.0 ml, p < 0.001). All 14 patients were managed by laparoscopic cornuostomy or cornual repair. No one was converted to laparotomy. Post-operation pregnancy was uneventful. All neonates were delivered by cesarean section with no evident complications. ConclusionLaparoscopic cornuostomy or cornual repair appears to be an effective treatment for cornual heterotopic pregnancy, even in ruptured ones. These operations can be safely performed in an institution with well-trained gynecological laparoscopists with experienced support teams.

Diagnosis and management of heterotopic pregnancy following embryo transfer: clinical analysis of 55 cases from a single institution.

The aims of this study were to summarize the clinical features of patients with heterotopic pregnancy (HP) following embryo transfer (ET) and explore the risk factors for miscarriage after surgery. All patients with HP following ET treated by surgery between August 2014 and August 2015 in Chongqing Health Center for Women and Children were retrospectively reviewed. Fifty-five patients were identified, including 40 with tubal HP, 9 interstitial HP and 6 cornual HP. The most frequent manifestations before diagnosis was abdominal pain (29.1%), while 19 patients (34.5%) had no symptoms before diagnosis. The sensitivity of symptoms for HP was 65.5%. Gestational age atsymptomonset of these patients with symptoms (n=36) was 5.8weeks (range 4.7-8.1). Forty-seven patients (85.5%) were suspected of HP when they received first transvaginal ultrasonography (TVS). The mean gestational age at diagnosis was 6.3weeks (range 4.7-8.3, 16-41days after ET). First TVS suggesting HP (P=0.000) and first TVS performed before day 27 (P=0.000) were two independent predictors for gestational age at diagnosis. Gestational age at surgery day was 6.7weeks (range 5.3-10.7). Fifty-one patients (92.7%) resulted in a live birth. Gestational age at surgery day was the only independent risk factor for miscarriage in patients with HP treated by laparotomy (OR 0.003, 95%CI 0.001-0.604). Routine TVS at day 27 after ET could facilitate the diagnosis of HP, symptoms onset before or after day 27 are clues to early diagnosis. Prompt surgery after diagnosis may improve the prognosis of HP following ET.

Successful management of heterotopic cornual pregnancy with laparoscopic cornual resection

ObjectiveTo examine the feasibility of laparoscopic cornual resection for the treatment of heterotopic cornual pregnancy. Study designWomen who underwent laparoscopic cornual resection for heterotopic cornual pregnancy at our hospital between January 2003 and March 2015 were retrospectively analyzed. We evaluated significant parameters such as operative complications and postoperative pregnancy outcomes of concomitant pregnancy. ResultsThirteen patients with heterotopic cornual pregnancy were included in the study. All were pregnant through assisted reproductive technology, and the diagnosis was made at a median of 6+6 weeks (range 5+4–10+0). They were successfully treated with laparoscopic cornual resection and admitted for a median of 4 days (range, 2–7) postoperatively. The median operative time was 65min (range, 35–145min) and estimated blood loss was 200mL (range, 10–3000mL). There was a spontaneous abortion at 7+6 gestational weeks in a patient who received bilateral cornual resection. Seven patients delivered babies at term and 3 at preterm. All 10 women delivered without any maternal or neonatal complications. Two were lost to follow-up. ConclusionsLaparoscopic cornual resection is a feasible primary approach for the management of heterotopic cornual pregnancy.

Abdominal resection of a cornual heterotopic pregnancy using intraoperative ultrasound: case report

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.

Laparoscopic resection of cornual heterotopic pregnancy after in vitro fertilization and embryo transfer leading to successful live birth

Abstract Heterotopic cornual pregnancy refers to the co-existence of intrauterine and extrauterine cornual pregnancies. This is rare, but the incidence increases in pregnancies associated with in vitro fertilization and embryo transfer (IVF-ET). A 36 year old gravida 2 para 0 woman with a history of bilateral salphingectomy underwent IVF-ET and was diagnosed with a heterotopic cornual pregnancy. She underwent diagnostic laparoscopy and wedge resection of the right cornual ectopic pregnancy. The intrauterine pregnancy progressed uneventfully and was delivered via caesarean section at 36 + 6 weeks. This case report illustrates the importance of early diagnosis of the condition, and how meticulous surgical technique is effective in removing the cornual ectopic pregnancy while preserving the intrauterine pregnancy.

Cornual heterotopic pregnancy after bilateral salpingectomy and uterine septum resection resulting in term delivery of a healthy infant.

Heterotopic pregnancy is the simultaneous occurrence of two or more implantation sites. A 25-year-old infertile patient with a history of bilateral salpingectomy, uterine septum resection, and left cornual resection was diagnosed with heterotopic pregnancy in her second in vitro fertilization trial. She attended our clinic when she was 7-week pregnant, complaining initially of severe abdominal pain. Findings associated with peritoneal irritation were positive during the physical examination. Transvaginal ultrasound revealed right cornual ectopic pregnancy with a live fetus in the middle of the uterine cavity. Also free fluid was noted in the pelvis. A diagnosis of heterotopic pregnancy with rupture of the cornual pregnancy was made. She underwent emergency laparoscopy with aspiration of the ruptured ectopic pregnancy, suturing to the entire visible cornual margins, and assurance of good haemostasis. Her recovery was uneventful and she continued receiving care in our obstetric unit. She delivered a healthy newborn by cesarean section at term.

Full-term delivery in patient with heterotopic cornual pregnancy via selective fetal reduction with potassium chloride

병합임신이란 자궁강내 임신과 자궁외임신이 동반되는 것으로 정의된다. 자연발생률은 1/30,000 정도로 매우 낮으나 보조생식술을 시행한 경우 1/7,000 정도로 발생 위험이 증가하므로 보조생식술을 시행하였을 경우에는 반복적인 초음파 관찰을 통해 조기 진단하는 것이 중요하다. 치료로는 수술적, 약물적 방법이 있고 이 중 안전하게 자궁내임신을 유지시키면서 효과적으로 치료하는 방법이 늘어나는 추세이다. 저자들은 보조생식술을 시행한 환자에게서 발생한 자궁각 임신을 동반한 병합임신에서 자궁각내 염화칼륨을 주입하여 선택적으로 태아감축술을 시행한 후 정상 자궁내임신을 유지하여 만삭분만에 성공한 증례를 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다.