Live birth after treatment of a ruptured ectopic in a spontaneous heterotopic pregnancy

Heterotopic pregnancy, though more common in pregnancies achieved by assisted reproduction, is extremely rare following natural conception. Owing to this rarity, the diagnosis is oftentimes missed or made late, usually following rupture of the extrauterine gestation. Heterotopic pregnancy, therefore...

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Bibliographic Details
Published inNigerian journal of medicine Vol. 30; no. 4; pp. 476 - 477
Main Authors Ubom, Akaninyene, Owolabi, Alexander, Fadare, Oluwatoyin, Akindojutimi, Jerrie, Adekunle, Isiaka
Format Journal Article
LanguageEnglish
Published Wolters Kluwer India Pvt. Ltd 01.07.2021
Medknow Publications and Media Pvt. Ltd
Wolters Kluwer Medknow Publications
Subjects
Care and treatment
Chorionic gonadotropin
ectopic pregnancy
Glycoproteins
Health aspects
heterotopic pregnancy
laparotomy
Mortality
natural conception
Nigeria
Pregnant women
salpingectomy
Nigeria
natural conception
Ectopic pregnancy
heterotopic pregnancy
salpingectomy
laparotomy
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Summary:Heterotopic pregnancy, though more common in pregnancies achieved by assisted reproduction, is extremely rare following natural conception. Owing to this rarity, the diagnosis is oftentimes missed or made late, usually following rupture of the extrauterine gestation. Heterotopic pregnancy, therefore, expectedly carries significant maternal mortality and morbidity. With the advancement in assisted reproductive techniques, and improvement in the diagnosis of ectopics using transvaginal ultrasound and beta-human chorionic gonadotropin assay, the frequency of heterotopic pregnancy is likely to increase, especially so in a country like Nigeria, with high twinning and ectopic pregnancy rates. To promptly diagnose heterotopic pregnancy and timely intervene, a high level of clinical suspicion is required. This would mitigate maternal morbidity and mortality, as well as preserve and continue the intrauterine pregnancy. With early diagnosis and prompt intervention, intrauterine pregnancy has a favourable outcome in the majority of cases. We present a 37-year-old multigravida with naturally conceived heterotopic pregnancy, in which the ectopic pregnancy ruptured. She subsequently had spontaneous vaginal delivery following surgical management (laparotomy) of the ruptured ectopic pregnancy.
ISSN:1115-2613
2667-0526
DOI:10.4103/NJM.NJM_101_21