Heterotopic pregnancy with term delivery after rupture of a first-trimester tubal pregnancy. A case report.
BACKGROUND
Because heterotopic pregnancy is rare, the presence of an intrauterine pregnancy tends to impede early diagnosis and definitive intervention for the ectopic component. Delay in diagnosing the condition and failure to proceed quickly with the requisite anesthesia and surgery can jeopardize both maternal well-being and survival of the intrauterine fetus.


METHODS
A patient with heterotopic pregnancy carried the intrauterine pregnancy to term following first-trimester rupture of the tubal pregnancy, with hypovolemic shock.


CONCLUSIONS
Prompt diagnosis, rapid fluid and blood resuscitation, heart-sparing anesthesia and gentle, expeditious surgery collectively contributed to the favorable outcome for the mother and surviving infant.
Department of Obstetrics and Gynecology, Wyckoff Heights Medical Center, Brooklyn, New York 11237, USA.
P C
PC
Chandra
H J
HJ
Schiavello
S L
SL
Briggs
J D
JD
Samuels
D000328:Adult; D000758:Anesthesia / Q000379:methods; D001803:Blood Transfusion; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D005440:Fluid Therapy; D005865:Gestational Age; D006801:Humans; D010100:Oxygen / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011274:Pregnancy, Tubal / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D012422:Rupture, Spontaneous; D012769:Shock / Q000209:etiology / Q000628:therapy; D016216:Ultrasonography, Prenatal
D010100:Oxygen