title: Heterotopic triplet pregnancy. Report of a case with successful twin intrauterine gestation.
abstract: BACKGROUND
  Reports of coexisting multiple intrauterine pregnancies and ectopic pregnancy are extremely rare. We present one case with early sonographic diagnosis of heterotopic pregnancy, successful laparoscopic treatment and a subsequent normal pregnancy course and outcome of the intrauterine twin gestation.
  
  
  METHODS
  A 29-year-old woman, gravida 1, para 0, presented for her first prenatal visit at 5 weeks of gestation with pelvic pain. She had conceived with 75 IU leutinizing hormone and follicle-stimulating hormone and homologous intrauterine insemination. The sonogram confirmed a dichorionic twin intrauterine pregnancy and left tubal pregnancy at 7 weeks of gestation. The patient underwent a laparoscopic left salpingostomy and removal of the ectopic pregnancy. Level II sonogram showed a grossly unremarkable twin gestation at 20 weeks. Labor was induced at 37 weeks of gestation due to mild preeclampsia and underwent vaginal delivery without difficulties. The first twin was a girl, weighing 2,722 g, with Apgar scores of 9/9. The second twin, a boy, was delivered 10 minutes later, weighing 2,863 g, with Apgar scores of 9/9.
  
  
  CONCLUSIONS
  Early sonography is essential for the diagnosis of heterotopic pregnancy, and timely surgical intervention can save the intrauterine twin gestation, with a subsequent normal pregnancy course and outcome.
authors.affiliation: Department of Obstetrics and Gynecology, Winthrop University Hospital, Mineola, New York 11501, USA.
authors.forename: I
authors.initials: I
authors.lastname: Berliner
authors.forename: M
authors.initials: M
authors.lastname: Mesbah
authors.forename: I
authors.initials: I
authors.lastname: Zalud
authors.forename: D
authors.initials: D
authors.lastname: Maulik
mesh_terms: D000328:Adult; D005187:Fallopian Tubes / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging*; D014310:Triplets; D016216:Ultrasonography, Prenatal; D014599:Uterus / Q000000981:diagnostic imaging