A Very Rare Case of Heterotopic Pregnancy in Natural Conception with Ectopic Pregnancy as Partial Mole!

Excerpt

Heterotopic pregnancy is defined as the coexistence of intrauterine and extrauterine gestation. It was first reported in 1708 as an autopsy finding. The incidence was originally estimated on theoretical basis to be 1 in 30,000 pregnancies. However, more recent data indicate that the rate is higher because of assisted reproduction and is approximately 1 in 7,000 overall and as high as 1 in 900 with ovulation induction. There might be an increased risk in patients with previous tubal surgeries. Heterotopic pregnancy can have various presentations. It should be considered more likely in the following cases: (a) after assisted reproduction techniques, (b) with persistent or rising chorionic gonadotropin levels after dilatation and curettage for an induced/spontaneous abortion, (c) when the uterine fundus is larger than for menstrual dates, (d) when more than one corpus luteum is present in a natural conception, and (e) when vaginal bleeding is absent in the presence of signs and symptoms of ectopic gestation. The treatment of a heterotopic pregnancy is laparoscopy/laparotomy for the tubal pregnancy. …