Heterotopic triplets: tubal ectopic and twin intrauterine pregnancy. A review of obstetric outcomes with a case report.
BACKGROUND
Heterotopic triplets hardly take place, but nowadays the extended use of assisted reproductive technologies is increasing the ectopic pregnancies rate and subsequently the heterotopic pregnancies, leading to a potentially dangerous condition for the woman and the intrauterine pregnancy.


METHODS
Fourteen cases previously reported in the literature of patients presenting an intrauterine twin pregnancy which became complicated by a tubal ectopic pregnancy have been reviewed. The case of a patient following a homologous intrauterine insemination treatment, resulting in live birth of both twins, is also described.


CONCLUSIONS
Although the diagnosis of heterotopic triplets with tubal ectopic is challenging, a timely surgical treatment will preserve intrauterine gestation with a great chance of a successful obstetric outcome for both twins.
Bugatto
Fernando
F
Department of Obstetrics and Gynaecology, Division of Maternal-Fetal Medicine, Puerta del Mar University Hospital, Avda. Ana de Viya 21, Cádiz, Spain. fgbugatto@yahoo.com
Quintero-Prado
Rocío
R
Kirk-Grohar
Janette
J
Melero-Jiménez
Victoria
V
Hervías-Vivancos
Blas
B
Bartha
José L
JL
D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D050498:Live Birth; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D014310:Triplets; D016216:Ultrasonography, Prenatal