A Case of Term Delivery in Heterotopic Pregnancy following a Natural Conception.

Kim, So Hee; Jung, Myeong Su; Jung, Ju Sup; Mun, Tae Sik; Lee, Sang Eon

In Vitro

Korean Journal of Obstetrics & Gynecology 2006;49(5):1158-1164.
Published online May 1, 2006.

A Case of Term Delivery in Heterotopic Pregnancy following a Natural Conception.

So Hee Kim, Myeong Su Jung, Ju Sup Jung, Tae Sik Mun, Sang Eon Lee

¹Department of Obstetrics and Gynecology, Good Samsun Hospital, Busan, Korea. jjusup@lycos.co.kr
²Department of Obstetrics and Gynecology, Pusan Adventist Hospital, Busan, Korea.

Abstract

Heterotopic pregnancy, simultaneous intrauterine and extrauterine gestations, is a relatively rare conditon with an estimated incidence of 1 in 30,000 pregnancies in a natural cycle. But the incidence of heterotopic pregnancies has been increased because of rising incidence of pelvic inflammatory disease, pelvic surgery, intrauterine device, the use of various ovulation induction and assisted reproductive technologies, such as in vitro fertilization and embryo transfer, gamate intrafallopian insemination. The early diagnosis of heterotopic pregnancy is very difficult. So there is a higher maternal morbidity, mortality and fetal loss. Thus careful pelvic examination, combined with serial beta hCG determinations and transvaginal sonography to evaluate the adnexal region are important. We experienced a case of 34-years-old multiparous women with heterotopic pregnancy in natual cycle confirmed by surgical removal of ruptured right tubal pregnancy and sonographic finding of the intrauterine pregnancy, which carried the intrauterine pregnancy to term delivery without complication at 39+5 weeks of gestation, and report this case with a brief review of the literature.

Key Words: Heterotopic pregnancy, Natural cycle