Heterotopic pregnancy after in vitro fertilization and embryo transfer: a case report.
2012
Introduction. Heterotopic pregnancy is a life-threatening complication of
pregnancy defined as coexistent intrauterine and ectopic gestation. Its
diagnosis is frequently overlooked and delayed. Case Outline. A 28-year-old
woman experienced acute abdominal pain in pregnancy achieved by in vitro
fertilization. Since all previous checkups indicated a normal course of
pregnancy, the ectopic pregnancy was not suspected on admission. However, due
to persistent hypotension, this diagnosis was also considered. Transvaginal
ultrasound performed by an experienced obstetrician revealed an adnexal mass
highly indicative of ectopic pregnancy. No fetal heart beats were visualized
and the diagnosis of a missed abortion was made. A prompt laparotomy revealed
a ruptured right ampullary pregnancy, and salpingectomy was performed.
Conclusion. Although rare, heterotopic pregnancy should be considered in the
differential diagnosis of abdominal pain in pregnancy. Every physician
treating women of reproductive age should bear in mind the possibility of
heterotopic pregnancy not only in patients with predisposing risk factors but
also in those without them.
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