title: Heterotopic triplet pregnancy: report of a case with bilateral tubal pregnancy and an intrauterine pregnancy.
abstract: The first report of an ectopic pregnancy following IVF was published in 1976, and since then heterotopic pregnancies (HPs) have been reported at an increasing rate. Although cases of the co-existence of a bilateral tubal and an intrauterine pregnancy following IVF-embryo transfer have been reported, a case of heterotopic triplet pregnancy caused by unilateral tubal embryo transfer has not yet been published in the literature. Here we report on a 38-year-old women (gravida 3, para 1) with a history of infertility who presented to our infertility clinic for evaluation. Hysterosalpingography revealed bilaterally patent Fallopian tubes and stricture of the cervical canal. She conceived after receiving HMG combined with pure FSH, followed by IVF-tubal embryo transfer. Four embryos were replaced into the right tube. Approximately 5 weeks after tubal embryo transfer, the patient presented with lower abdominal tenderness and shock due to internal bleeding. She underwent an emergency laparotomy under the impression of HP. Bilateral tubal pregnancy with right tubal rupture was noted during the operation. The post-operative course was uneventful. Early intervention and thorough inspection of the peritoneal cavity in patients with haemodynamic instability can prevent jeopardizing the life of the mother as well as the ongoing pregnancy.
authors: Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shih Lin District, Taipei, Taiwan.
authors: Hun-Shan
authors: HS
authors: Pan
authors: Jesse
authors: J
authors: Chuang
authors: Su-Fang
authors: SF
authors: Chiu
authors: Bih-Chwen
authors: BC
authors: Hsieh
authors: Yu-Hung
authors: YH
authors: Lin
authors: Yieh-Loong
authors: YL
authors: Tsai
authors: Shih-Chia
authors: SC
authors: Huang
authors: Mei-Ling
authors: ML
authors: Hsieh
authors: Chin-Yu
authors: CY
authors: Chen
authors: Jiann-Loung
authors: JL
authors: Hwang
mesh_terms: D000328:Adult; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008297:Male; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging / Q000601:surgery; D011272:Pregnancy, Multiple; D014310:Triplets; D016216:Ultrasonography, Prenatal