Spontaneus Heterotopic pregnancy, case report and literature review

Background and Aim : The majority site of ectopic pregnancies is fallopian tube (96 percent),otherpossible sites include:cervical,interstitial of the fallopian tube,hysterotomy scar,intramural,ovarian,andabdominal. in rare cases,there are both intra and extera uterine pregnancy,it is called heterotopic orcombined pregnancy.the incidence of heterotopic pregnancy is 1 in 30,000 pregnancies.as we know,theincidence rate is increased with assisted reproduction techniques.We present a rare case of heterotopicpregnancy with live intrauterine gestation and ruptured right fallopian tube in a natural conception,withoutany known risk factors. The patient is a 27 year old woman,gravid3,para1,live1 and abortion1,at 10 weeksand 1 days by last menstrual period and 9 weeks and 4 days by her first sonogram.She presented to theemergency room complaining of lower abdominal pain form 3 days ago.the pain had worsened the daybefore.in physical examination her abdomen was distended and tender more on the right side than left side.Pelvic ultrasound revealed both live intrauterine and exterauterine pregnancy of 9 weeks and 3 days withmoderate to severe hemoperitoneum.She had an emergency laparotomy with right salpingectomy.Wesupported the alive intrauterine pregnancy with administering cyclogest suppository.Methods : a case reportResults : a case reportConclusion : The incidence of heterotopic pregnancy in a woman with no prior risk factor is rare but itshould be considered in a confirmed intrauterine pregnant woman with abdominal pain.

کلیدواژه ها:

heterotopic pregnancy ، Ectopic pregnancy ، natural conception ، salpingectomy