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  1. Fulltext A rare case of heterotopic quintuplets pregnancy
    Wu D, Hii LY, Shaw SWS
    Taiwan J Obstet Gynecol, 2019 Sep;58(5):684-687.
    PMID: 31542093 DOI: 10.1016/j.tjog.2019.07.018
    OBJECTIVE: We report a rare case of heterotopic pregnancy and high-order pregnancy occurring simultaneously following the use of the assisted reproductive technique (ART).

    CASE REPORT: A 29-year-old woman, Gravida 2 Para 1, became pregnant after receiving intrauterine insemination (IUI). She came to our emergency room due to diffuse low abdominal pain at seven weeks of gestational age. Transabdominal sonography (TAS) revealed a quadruplet intrauterine pregnancy with an enlarged left adnexa and intrapelvic fluid accumulation. Simultaneous occurrence of high-order pregnancy and left tubal pregnancy with internal hemorrhage was suspected. The patient received an emergent laparoscopic resection of the affected Fallopian tube and recovered well for the remaining hospitalization course. Afterwards, she received fetal reduction procedure and eventually gave birth to twin babies.

    CONCLUSION: Gynecologist should increase the awareness of heterotopic pregnancy in patients receiving ART. On the other hand, reproductive endocrinologist should reduce the risk of high-order pregnancy without compromising pregnancy rate.

    Matched MeSH terms: Pregnancy, Heterotopic/etiology*; Pregnancy, Heterotopic/surgery
  2. Fulltext The challenge in diagnosing and managing heterotopic interstitial pregnancy in natural conception
    Noor Azura Noor Mohamad, Suzanna Daud, Sun Ta Thow, Darminder Singh Chopra, Bahiyah Abdullah
    Journal of Clinical and Health Sciences, 2019;4(2):86-90.
    MyJurnal
    Heterotopic interstitial pregnancy in natural conception is very rare. Definitive diagnosis is
    made by systematic pelvic ultrasound. Simultaneous viable conception observed in both intraand extra-uterine is pathognomonic of heterotopic interstitial pregnancy. We report a 34-yearold woman primigravida at 10 weeks’ amenorrhoea who underwent evacuation of retained
    product of conception for missed miscarriage. Intraoperatively, minimal product of conception
    was retrieved. Bedside pelvic ultrasound showed cystic mass at right superolateral part of
    uterine fundus suspicious of interstitial pregnancy. Cornual resection was performed via
    laparotomy. Histopathological examination showed presence of product of conception and
    interstitial pregnancy. Serum β-human chorionic gonadotropin dropped from 10,027 IU/l on day
    one post-ERPC to 210 IU/l at day three post-cornual resection. This case report highlighted
    the challenge in diagnosing heterotopic interstitial pregnancy conceived naturally. Timely
    diagnosis may avert dire consequences of massive haemorrhage from ruptured uterine cornua
    Matched MeSH terms: Pregnancy, Heterotopic
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