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Online ISSN
1305-3124

Established
1993

Editors-in-Chief
​Cihat Şen, ​Nicola Volpe

Editors
Daniel Rolnik, Mar Gil, Murat Yayla, Oluş Api

Statistics Editor
Resul Arısoy

Ultrasound diagnosis and laparoscopic treatment of a heterotropic pregnancy

Ismet Hortu, Gökay Özçeltik, Deniz Şimşek, Ahmet Mete Ergenoğlu, Ahmet Özgür Yeniel

Article info

Ultrasound diagnosis and laparoscopic treatment of a heterotropic pregnancy. Perinatal Journal 2014;22(3):SE37-38 DOI: 10.2399/prn.14.S001084

Author(s) Information

Ismet Hortu,
Gökay Özçeltik,
Deniz Şimşek,
Ahmet Mete Ergenoğlu,
Ahmet Özgür Yeniel

  1. Ege Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı- İzmir TR
Correspondence

Ismet Hortu, Ege Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı- İzmir TR,

Publication History
Conflicts of Interest

No conflicts declared.

Heterotropic pregnancy is a rare condition in which both intrauterine and extrauterine pregnancies are present at the same time. This rare condition is a serious emergency that can be life-threatening due to bleeding in cases of delayed diagnosis. The main goal of treatment is to maintain the intrauterine pregnancy while terminating the extrauterine pregnancy. Termination of extrauterine pregnancy can be carried out using either surgical treatments or non-surgical treatments. The management remains controversial. In case of a diagnosis of heterotopic pregnancy is hemodynamically stable, conservative management may be considered. Non-surgical treatments consists of administration of several drugs to the extrauterine gestational sac under ultrasonographic or laparoscopic guidance. Surgical treatment is warranted when conservative treatment fails or there is accompanying hemoperitoneum. Surgery can be performed either with laparotomy or laparoscopic approach. Since laparoscopic approach has several advantages over laparatomy including reduced recovery time, reduced requirement for antibiotics and analgesics. We report a case of a 31 year old woman who was admitted through emergency department with delayed menstruation and vaginal bleeding. Her ultrasound scan revealed heterotopic pregnancy with one intrauterin fetus of about 7 weeks and the second fetus of about 7 weeks in the left tubal area, both with fetal cardiac activity. She was hemodynamically stable at the time of presentation. After the patient and her husband were given informed consent she underwent laparoscopy and left salpingo-oophorectomy was performed. On the second day after surgery she was discharged from the hospital. Two weeks after the surgery the patient was called for control and her ultrasound revealed an ongoing intrauterine live pregnancy.
Keywords

Heterotopic pregnany, laparoscopic surgery

File/Dsecription
Figure 1
2d vaginal ultrasound of heterotopic pregnancy
Figure 2
3d vaginal ultrasound of heterotopic pregnancy
Figure 3
Laparoscopic image of left tubal ectopic pregnancy