Heterotopic pregnancy refers to the simultaneous development of an intrauterine pregnancy and an extrauterine pregnancy. We experienced a case of a ruptured heterotopic pregnancy for a patient with a history of a right segmental salpingectomy from an ectopic pregnancy. The 30-year-old patient with amenorrhea for six weeks complained of lower abdominal pain with hypovolemic shock. Transabdominal ultrasonography showed diffuse hemoperitoneum with a structure similar to an ectatic tube or a deformed cyst with no echogenic double ring or peripheral hypervascularity in the right adnexa and an intrauterine gestational sac. We considered a ruptured corpus luteum cyst as an ultrasonographic finding and found a ruptured tubal mass in the right salpinx and hemoperitoneum through an emergency laparotomy. We performed a right salpingectomy, and the histopathologic report confirmed ectopic pregnancy.
Abdominal Pain ; Adult ; Amenorrhea ; Emergencies ; Fallopian Tubes ; Female ; Gestational Sac ; Hemoperitoneum ; Humans ; Laparotomy ; Ovarian Cysts ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Tubal ; Salpingectomy ; Shock

Heterotopic pregnancy is defined as coexistence of intrauterine and ectopic pregnancy. The reported incidence of heterotopic pregnancy, which is normally rare, is particularly high (1%) after IVF treatment. It is important to have a high index of suspicion for the occurrence of heterotopic pregnancies because only 40% to 84% of cases can be diagnosed with transvaginal ultrasound at the initial presentation. Edwards syndrome occurs in 8,000 newborns and the incidence is much higher in elderly gravidas. We report a case of heterotopic pregnancy following IVF-ET resulting in 16 weeks of intrauterine pregnancy with fetal Edwards syndrome, and tubal pregnancy with a brief review of literature.
Aged ; Female ; Humans ; Incidence ; Infant, Newborn ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Tubal

Heterotopic pregnancy occurs when an intrauterine pregnancy co-exists with an ectopic pregnancy. It is a potentially fatal condition, rarely occuring in natural conception cycle. But its incidence is increased since the rise in PID, pelvic surgery, IUD, and advent of assisted reproductive technology involving use of superovulatory drugs and/or in vitro-fertilization. We present a case of intrauterine twin pregnancy and right tubal pregnancy following treatment with in vitro-fertilization. The right tubal pregnancy was diagnosed after rupturing at 6th gestational weeks, and resected via laparoscopy. And healthy twin babies were delivered without complication at 38th gestational week. So we report this case with a brief review of the literatures.
Female ; Fertilization ; Humans ; Incidence ; Laparoscopy ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic* ; Pregnancy, Tubal ; Pregnancy, Twin ; Reproductive Techniques, Assisted

Heterotopic pregnancy is an unusual condition that intrauterine pregnancy is accompanied by a coexisting ectopic pregnancy. The incidence of heterotopic pregnancies has increased in recent years because of rising incidence of pelvic inflammatory disease, pelvic surgery, expanding use of assisted reproductive technology. We report a rare case with heterotopic pregnancy following ovulation induction and intrauterine insemination that was diagnosed after rupture of the ectopic pregnancy. After surgical removal of the ruptured left tubal pregnancy, she carried the intrauterine pregnancy to term without any complications.
Female ; Incidence ; Insemination ; Ovulation ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Tubal ; Reproductive Techniques, Assisted ; Rupture

Heterotopic pregnancy is an unusual condition that intrauterine pregnancy is accompanied by a coexisting ectopic pregnancy. The incidence of heterotopic pregnancies has increased in recent years because of rising incidence of pelvic inflammatory disease, pelvic surgery, expanding use of assisted reproductive technology. We report a rare case with heterotopic pregnancy following ovulation induction and intrauterine insemination that was diagnosed after rupture of the ectopic pregnancy. After surgical removal of the ruptured left tubal pregnancy, she carried the intrauterine pregnancy to term without any complications.
Female ; Incidence ; Insemination ; Ovulation ; Ovulation Induction ; Pelvic Inflammatory Disease ; Pregnancy ; Pregnancy, Ectopic ; Pregnancy, Heterotopic ; Pregnancy, Tubal ; Reproductive Techniques, Assisted ; Rupture

Although a higher incidence of ectopic pregnancy has been reported after in vitro fertilization(IVF) and embryo transfer(ET), five ectopic pregnancies in one patient is very rare. We experienced a case of combined interstitial and intrauterine pregnancy as fifth ectopic pregnancies after in vitro fertilization and embryo transfer in one patient with history of bilateral salpingectomy due to previous four tubal pregnancies. Repeated transvaginal ultrasound examinations confirmed heterotopic pregnancy. In IVF-ET, bilateral salpingectomy does not remove the risk of interstitial or cornual pregnancy.
Embryo Transfer* ; Embryonic Structures* ; Female ; Fertilization in Vitro* ; Humans ; Incidence ; Pregnancy* ; Pregnancy, Ectopic* ; Pregnancy, Heterotopic ; Pregnancy, Tubal ; Salpingectomy* ; Ultrasonography

Heterotopic pregnancy or the coexistence of an intrauterine and an extrauterine pregnancy occurs in about 1 out of 30,000 pregnancies. Between assisted reproductive techniques and ovulation induction, it is said to occur more commonly with the former. The patient presented in this case is a 29 year old primigravid who underwent ovulation induction with clomiphene citrate and was later on diagnosed to have both an intrauterine and a non-viable extrauterine pregnancy. The management for this kind of pregnancy can be medical, surgical or expectant. The patient in this case was managed expectantly. This case study presents a review of literature on heterotopic pregnancy, and describes how this rare type of pregnancy developed in this index patient, how it is diagnosed and managed, and to showcase how expectant management can be a safe option for cases of heterotopic pregnancy.
Pregnancy, Heterotopic ; Pregnancy, Ectopic ; Clomiphene

Approximately 1% of ectopic pregnancies are abdominal and may result in life threatening complication. In particular, the omental pregnancy is exceedingly rare and less than 10 cases of omental pregnancy were reported in the world. Even some author insisted there is no real omental pregnancy. Actually the abdominal pregnancy was the result of abortion or rupture of tubal pregnancy or rarely abdominal implantation after uterine rupture. In several select first trimester patients with abdominal pregnancies, laparoscopic managements. were recently reported. We report the first case of omental pregnancy, which diagnosed by chance at diagnostic laparoscopy, 6 weeks after her last menstrual period.
Female ; Humans ; Laparoscopy ; Pregnancy Trimester, First ; Pregnancy* ; Pregnancy, Abdominal ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Rupture ; Uterine Rupture

Ectopic pregnancy is an implantation of the fertilized ovum outside the uterine cavity. Most of ectopic pregnancies are located within the fallopian tube. We describe a rare case of 34-year-old woman complaining of lower abdominal pain and positive urinary pregnancy test. Pelvic ultrasound exam suggested tubal pregnancy with hemoperitoneum. However, pelviscopy revealed the bleeding point was subserosal myoma located just next to the right ovary. Uterus and both fallopian tubes were grossly free. Laparoscopic myomectomy with ectopic mass excision was performed and we observed the serial decrease of beta-hCG level. Patient was well recovered and postoperative finding was not remarkable. Hereby, we report a rare case of ectopic pregnancy on uterine myoma with subserosal type with a brief review of literatures.
Abdominal Pain ; Adult ; Fallopian Tubes ; Female ; Hemoperitoneum ; Hemorrhage ; Humans ; Laparoscopy ; Leiomyoma* ; Myoma ; Ovarian Neoplasms ; Ovary ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Ultrasonography ; Uterus ; Zygote

Laparoscopic management is the ideal form of treatment for tubal pregnancy, most common type of ectopic pregnancy. Not only abdominal pregnancy including intraligamentary pregnancy is an rare form of ectopic pregnancy, but intraligamentary pregnancies are usually diagnosed and managed by emergency explorative laparotomy. We present the case of an intraligamentary pregnancy of a 28-year-old woman managed by laparoscopic treament without any complication.
Adult ; Emergencies ; Female ; Humans ; Laparoscopy ; Laparotomy ; Pregnancy ; Pregnancy, Abdominal ; Pregnancy, Ectopic ; Pregnancy, Tubal