Heterotopic pregnancy

Heterotopic pregnancy is a rare situation when there is an intra-uterine and extra-uterine pregnancy occurring simultaneously.

The estimated incidence in the general population is estimated at 1:30,000 (for a naturally conceived pregnancy 7). The incidence among patients with assisted reproduction is higher and is thought to be around 1-3:100 2. Due to this, the overall incidence has increased over the years.

Heterotopic pregnancies have been diagnosed from 5-34 weeks of gestation with up to 70% diagnosed between 5-8 weeks of gestation, 20% between 9-10 weeks and only 10% after the 11th week 6.

Risk factors

Recognised risk factors predisposing to this condition include:

Ultrasound

Classically shows features or a intra-uterine pregnancy as well as an ectopic pregnancy.

An ultrasound-guided ablation or laparoscopic removal of the extra-uterine fetus can be considered in patients who have a known heterotopic pregnancy to permit the intrauterine pregnancy to continue normally.

Medical management, although used successfully for an ectopic pregnancy, has a limited role in the management of heterotopic pregnancy as one must try to preserve and protect the intrauterine pregnancy.

Considerations include:

Ultrasound - obstetric
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Article Information

rID: 13338
System: Obstetrics
Synonyms or Alternate Spellings:
  • Concurrent intra uterine and extra uterine pregnancy
  • Simultaenous intra uterine and extra uterine pregnancy
  • Combined intra uterine and extra uterine pregnancy

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