title: Heterotopic pregnancy: two cases and a comparative review.
abstract: 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.
authors.affiliation: Center for Reproductive Medicine and Infertility Quirón Bilbao, Bilbao, Spain. gorkabz@euskalnet.net <gorkabz@euskalnet.net>
authors.forename: Gorka
authors.initials: G
authors.lastname: Barrenetxea
authors.forename: Lorea
authors.initials: L
authors.lastname: Barinaga-Rementeria
authors.forename: Arantza
authors.initials: A
authors.lastname: Lopez de Larruzea
authors.forename: Jon Ander
authors.initials: JA
authors.lastname: Agirregoikoa
authors.forename: Miren
authors.initials: M
authors.lastname: Mandiola
authors.forename: Koldo
authors.initials: K
authors.lastname: Carbonero
mesh_terms: 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*