Heterotopic pregnancy: two cases and a comparative review.
OBJECTIVE
To analyze the incidence, diagnostic, and therapeutic management of heterotopic pregnancy by comparing a review for the 1971-1993 period with the one carried out in the present study (1994-2004).


METHODS
Review of the literature.


METHODS
University teaching assisted reproductive technology (ART) center.


METHODS
Two case reports included in a comparative review of the literature on heterotopic pregnancy.


METHODS
Review of the published literature from January 1994 to December 2004 was performed by means of MEDLINE database. Medical subject heading words used were: heterotopic pregnancy, assisted reproductive technology, and ectopic pregnancy. A comparison with a previously reported review, including cases from 1971 to 1993.


METHODS
Comparative study of the diagnosis and treatment of ectopic pregnancy.


RESULTS
During the 1971-1993 period the definitive diagnosis of heterotopic pregnancy was performed by laparoscopy or laparotomy in 59% of cases. This proportion increased to 74% from 1994 to 2004. Likewise, the percentage of cases in which an early diagnosis was possible (performed before the ninth week of pregnancy) did not vary in any of the time periods evaluated (71% vs. 74%).


CONCLUSIONS
Despite the increased medical knowledge and use of improved reproductive technologies, heterotopic pregnancy still remains a diagnostic and therapeutic challenge to practitioners.
Barrenetxea
Gorka
G
Center for Reproductive Medicine and Infertility Quirón Bilbao, Bilbao, Spain. gorkabz@euskalnet.net <gorkabz@euskalnet.net>
Barinaga-Rementeria
Lorea
L
Lopez de Larruzea
Arantza
A
Agirregoikoa
Jon Ander
JA
Mandiola
Miren
M
Carbonero
Koldo
K
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D007813:Laparotomy / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data*