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Spontaneous Heterotopic Triplet Pregnancy With Tubal Rupture: A Case Report and Literature Review.

Arsala L, Danso D - J Investig Med High Impact Case Rep (2014)

Bottom Line: We report the rare case of a multiparous woman with a spontaneous conception resulting in a triplet heterotopic pregnancy: a twin intrauterine pregnancy and a single right tubal ectopic pregnancy.Heterotopic pregnancy is a rare and potentially life-threatening condition in which simultaneous gestations occur at 2 or more implantation sites.It is infrequent in natural conception cycles, occurring in 1:30 000 pregnancies.

View Article: PubMed Central - PubMed

Affiliation: Royal Women's Hospital, Melbourne, Victoria, Australia.

ABSTRACT
The recent increase in heterotopic pregnancies has been largely attributed to the increased use of assisted reproduction technologies. We report the rare case of a multiparous woman with a spontaneous conception resulting in a triplet heterotopic pregnancy: a twin intrauterine pregnancy and a single right tubal ectopic pregnancy. Heterotopic pregnancy is a rare and potentially life-threatening condition in which simultaneous gestations occur at 2 or more implantation sites. It is infrequent in natural conception cycles, occurring in 1:30 000 pregnancies. However, the prevalence is rising with the increased use of assisted reproduction techniques to that of 1:100 to 1:500 in these patient subgroups, highlighting the need to incorporate it into a clinician's diagnostic algorithm.

No MeSH data available.


Related in: MedlinePlus

Transvaginal ultrasound of right adnexa showing the right tubal ectopic pregnancy (fetus C) with a gestational age of 6 weeks and cardiac activity.
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fig2-2324709614531556: Transvaginal ultrasound of right adnexa showing the right tubal ectopic pregnancy (fetus C) with a gestational age of 6 weeks and cardiac activity.

Mentions: A 27-year-old woman (gravida 5 para 2) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain in the setting of a recent positive home pregnancy test. Her last known menstrual period was 31 days prior to her presentation. She had no history of pelvic inflammatory disease, ectopic pregnancy, or fertility treatment. On physical examination, she was hemodynamically stable with a blood pressure of 110/60 mm Hg and heart rate of 82 beats/min. Abdominal examination demonstrated a distended abdomen with diffuse abdominal tenderness that was maximal in the right iliac fossa with rebound tenderness and signs of peritonism. Cervical tenderness was elicited during bimanual examination, with cervical excitation maximal in the right adnexa. Per speculum examination demonstrated a long, closed, posterior cervical os with no bleeding. Serum beta-hCG was 43 800 IU/L. Transvaginal sonography demonstrated 3 gestational sacs—2 intrauterine and 1 right adnexal—all with cardiac activity. The crown rump lengths (CRL) of the twin intrauterine fetuses were 6.7 mm and 3.6 mm corresponding to gestations of 6 weeks and 3 days and 5 weeks and 6 days, respectively (Figure 1). The right adnexal fetus had a CRL of 4.3 mm corresponding to a gestational age of 6 weeks (Figure 2). Ultrasonographic evidence of hemoperitoneum was present with a large amount of free fluid within the Pouch of Douglas.


Spontaneous Heterotopic Triplet Pregnancy With Tubal Rupture: A Case Report and Literature Review.

Arsala L, Danso D - J Investig Med High Impact Case Rep (2014)

Transvaginal ultrasound of right adnexa showing the right tubal ectopic pregnancy (fetus C) with a gestational age of 6 weeks and cardiac activity.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4528884&req=5

fig2-2324709614531556: Transvaginal ultrasound of right adnexa showing the right tubal ectopic pregnancy (fetus C) with a gestational age of 6 weeks and cardiac activity.
Mentions: A 27-year-old woman (gravida 5 para 2) presented to the emergency department with a complaint of sudden onset of right-sided lower abdominal pain in the setting of a recent positive home pregnancy test. Her last known menstrual period was 31 days prior to her presentation. She had no history of pelvic inflammatory disease, ectopic pregnancy, or fertility treatment. On physical examination, she was hemodynamically stable with a blood pressure of 110/60 mm Hg and heart rate of 82 beats/min. Abdominal examination demonstrated a distended abdomen with diffuse abdominal tenderness that was maximal in the right iliac fossa with rebound tenderness and signs of peritonism. Cervical tenderness was elicited during bimanual examination, with cervical excitation maximal in the right adnexa. Per speculum examination demonstrated a long, closed, posterior cervical os with no bleeding. Serum beta-hCG was 43 800 IU/L. Transvaginal sonography demonstrated 3 gestational sacs—2 intrauterine and 1 right adnexal—all with cardiac activity. The crown rump lengths (CRL) of the twin intrauterine fetuses were 6.7 mm and 3.6 mm corresponding to gestations of 6 weeks and 3 days and 5 weeks and 6 days, respectively (Figure 1). The right adnexal fetus had a CRL of 4.3 mm corresponding to a gestational age of 6 weeks (Figure 2). Ultrasonographic evidence of hemoperitoneum was present with a large amount of free fluid within the Pouch of Douglas.

Bottom Line: We report the rare case of a multiparous woman with a spontaneous conception resulting in a triplet heterotopic pregnancy: a twin intrauterine pregnancy and a single right tubal ectopic pregnancy.Heterotopic pregnancy is a rare and potentially life-threatening condition in which simultaneous gestations occur at 2 or more implantation sites.It is infrequent in natural conception cycles, occurring in 1:30 000 pregnancies.

View Article: PubMed Central - PubMed

Affiliation: Royal Women's Hospital, Melbourne, Victoria, Australia.

ABSTRACT
The recent increase in heterotopic pregnancies has been largely attributed to the increased use of assisted reproduction technologies. We report the rare case of a multiparous woman with a spontaneous conception resulting in a triplet heterotopic pregnancy: a twin intrauterine pregnancy and a single right tubal ectopic pregnancy. Heterotopic pregnancy is a rare and potentially life-threatening condition in which simultaneous gestations occur at 2 or more implantation sites. It is infrequent in natural conception cycles, occurring in 1:30 000 pregnancies. However, the prevalence is rising with the increased use of assisted reproduction techniques to that of 1:100 to 1:500 in these patient subgroups, highlighting the need to incorporate it into a clinician's diagnostic algorithm.

No MeSH data available.


Related in: MedlinePlus