[A heterotopic pregnancy].

Ned Tijdschr Geneeskd

Spaarne Gasthuis, afd. Gynaecologie.

Published: April 2020

Background: Heterotopic pregnancy is a rare but life-threatening situation. This is a situation where a woman has one or more intrauterine pregnancies and at least one ectopic pregnancy.

Case Description: Heterotopic pregnancy was discovered in a 37-year-old woman during a routine ultrasound check. This pregnancy occurred after intrauterine insemination with ovulation induction.

Conclusion: Heterotopic pregnancies require early diagnosis and treatment. Physicians should be extra vigilant when a woman has become pregnant after using assisted reproductive techniques, because these techniques increase the probability of heterotopic pregnancy. The symptoms of such pregnancies are similar to the symptoms of extrauterine gravidity. However, confirmed intrauterine gravidity does not exclude the existence of extrauterine gravidity. The diagnosis is based entirely on the transvaginal ultrasound. The intact intrauterine gravidity limits treatment options. Tubectomy is the treatment of first choice, but embryo aspiration could also be a safe method in certain circumstances.

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