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The Journal of Obstetrics and Gynecology of India
Published in: The Journal of Obstetrics and Gynecology of India 6/2018

01-12-2018 | Case Report

Heterotopic Quadruplet Pregnancy After ICSI Conception

Authors: Nupur A. Tamhane, Aditi Parikh, Vivek M. Joshi

Published in: The Journal of Obstetrics and Gynecology of India | Issue 6/2018

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Abstract

Background

Heterotopic pregnancy (HP) is a condition characterized by the coexistence of multiple fetuses at two or more implantation sites. It occurs in 1% of pregnancies after assisted reproductive techniques (ART). Presence of triplet intrauterine pregnancy with ectopic gestational sac is one of the rarest forms of HP. Ectopic pregnancy is implanted in the ampullary segment of the fallopian tube in 80% of cases. Most of the patients present with acute abdominal symptoms due to rupture of the tube.

Case Presentation

This article reports a case of quadruplet heterotopic pregnancy after intracytoplasmic sperm injection (ICSI) with an ampullary ectopic pregnancy and intrauterine triplet pregnancies. The ruptured ampullary pregnancy was emergently managed by right salpingectomy. This was followed by embryo reduction at 12 + 6 weeks and successful outcome of intrauterine twin pregnancy.
Literature
1.
Jeon JH, Hwang YI, Shin IH, et al. The risk factors and pregnancy outcomes of 48 cases of heterotopic pregnancy from a single center. J Korean Med Sci. 2016;31(7):1094–9.CrossRef
2.
Fisher SL, Massie JA, Blumenfeld YJ, et al. Sextuplet heterotopic pregnancy presenting as ovarian hyperstimulation syndrome and hemoperitoneum. Fertil Steril. 2011;95(7):e2431–3.CrossRef
3.
Zhang B, Cui L, Tang R, et al. Reduced ectopic pregnancy rate on day 5 embryo transfer compared with day 3: a meta-analysis. PLoS ONE. 2017;12(1):e0169837.CrossRef
4.
Li Z, Sullivan EA, Chapman M, et al. Risk of ectopic pregnancy lowest with transfer of single frozen blastocyst. Hum Reprod. 2015;30(9):2048–54.CrossRef
Metadata
Title
Heterotopic Quadruplet Pregnancy After ICSI Conception
Authors
Nupur A. Tamhane
Aditi Parikh
Vivek M. Joshi
Publication date
01-12-2018
Publisher
Springer India
Published in
The Journal of Obstetrics and Gynecology of India / Issue 6/2018
Print ISSN: 0971-9202
Electronic ISSN: 0975-6434
DOI
https://doi.org/10.1007/s13224-017-1049-5

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