Nonsurgical management of heterotopic abdominal pregnancy.
BACKGROUND
Heterotopic abdominal pregnancies with coexisting intrauterine pregnancies pose unique therapeutic challenges, and management options, particularly nonsurgical approaches, are limited.


METHODS
We present a case in which selective reduction of a heterotopic abdominal pregnancy during the second trimester using fetal intracardiac injection with potassium chloride enabled subsequent vaginal delivery of the intrauterine pregnancy at term. In addition, we summarize nine cases of nonsurgical management of heterotopic abdominal pregnancies, four of which involve potassium chloride selective reduction. Our case is unique in that the abdominal fetus remained as a stable lithopedion, allowing the uncomplicated conception and vaginal delivery of a second intrauterine pregnancy without need for surgical intervention.


CONCLUSIONS
Our case report and literature review demonstrate the use of selective potassium chloride reduction in managing heterotopic abdominal pregnancy nonsurgically.
Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA. yehj@alumni.stanford.edu
Judy
J
Yeh
Natali
N
Aziz
Jane
J
Chueh
D000328:Adult; D005260:Female; D006321:Heart; D006801:Humans; D007267:Injections; D011189:Potassium Chloride / Q000008:administration & dosage*; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal; D011269:Pregnancy, Abdominal / Q000175:diagnosis / Q000188:drug therapy*; D063192:Pregnancy, Heterotopic / Q000175:diagnosis / Q000188:drug therapy*
D011189:Potassium Chloride