[Spontaneous heterotopic pregnancy with live embryos: an insidious echographic problem in the first trimester. Therapeutic problems. A clinical case and review of the literature].
A case of spontaneous heterotopic pregnancy (simultaneous intra- and extrauterine) with living embryos is described. A 26 year old primigravida, affected by threatened abortion at 7 weeks gestation with right pelvic pain underwent a transvaginal sonography which allowed a certain diagnosis. A minilaparotomy with right salpingectomy was performed at the 8th week of gestation. Intrauterine pregnancy was uneventful and a healthy female infant was delivered at term weighting 3200 g. The international literature concerning heterotopic pregnancy is reviewed. Diagnostic and therapeutic aspects are discussed in the light of this case. Heterotopic pregnancy is an insidious pathology with a constant increase of incidence that should be considered as a diagnostic possibility in all cases at risk. Minilaparotomic salpingectomy in general anesthesia is probably the safest treatment for the patient and the least traumatic for a good outcome of her intrauterine pregnancy.
Clinica Ostetrica e Ginecologica, Univerità degli Studi Tor Vergata, Roma.
F
F
Giacomello
G
G
Larciprete
H
H
Valensise
C
C
Romanini
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging*; D011274:Pregnancy, Tubal / Q000000981:diagnostic imaging / Q000601:surgery; D016216:Ultrasonography, Prenatal
D005300:Fertility Agents, Female; D002996:Clomiphene