Heterotopic pregnancy in a spontaneous cycle: do not forget about it!
Heterotopic pregnancies are estimated to be less frequent than 1:30000 if no assisted reproduction technologies (ART) are performed. After ART this entity is more frequent and in the range of 1:100. In the case reported here an ectopic pregnancy was detected in the right fallopian tube at 7+ 1 weeks of gestation. It was misdiagnosed as an ectopic singleton, and treated by laparoscopic salpingectomy, because of a previous ectopic in the same tube. Rising hCG after laparoscopy during the subsequent days followed by ultrasound evaluation revealed a viable intrauterine pregnancy. The pregnancy continued uneventfully and a healthy child was delivered at term. The problems, which lead to the misdiagnosis are discussed. The problem of rare cases in medicine, and the problems of a 'modern' medicine are discussed.
Ludwig
M
M
Department of Gynecology and Obstetrics, Medical University of Lübeck, Germany. ludwig_m@t-online.de
Kaisi
M
M
Bauer
O
O
Diedrich
K
K
D006063:Chorionic Gonadotropin / Q000097:blood* / Q000652:urine; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011274:Pregnancy, Tubal / Q000601:surgery*
D006063:Chorionic Gonadotropin