Heterotopic pregnancy
Updates to Article Attributes
Heterotopic pregnancy is a rare situation when there is an intra-uterine and extra-uterine (i.e. ectopic) pregnancy occurring simultaneously.
Epidemiology
The estimated incidence in the general population is estimated at 1:30,000 (for a naturally conceived pregnancy 7). The incidence among patients with assisted reproduction is higher and is thought to be around 1-3:100 2. Due to this, the overall incidence has increased over the years.
Heterotopic pregnancies have been diagnosed from 5-34 weeks of gestation with up to 70% diagnosed between 5-8 weeks of gestation, 20% between 9-10 weeks and only 10% after the 11th week 6.
Pathology
Risk factors
Recognised risk factors predisposing to this condition include:
- use of an intrauterine contraceptive device
- prior tubal surgery
- history of pelvic inflammatory disease
- history of a previous ectopic pregnancy
Radiographic features
Ultrasound
Classically shows features or an intra-uterine pregnancy as well as an ectopic pregnancy.
ManagementTreatment and prognosis
An ultrasound-guided ablation or laparoscopic removal of the extra-uterine fetus can be considered in patients who have a known heterotopic pregnancy to permit the intrauterine pregnancy to continue normally.
Medical management, although used successfully for an ectopic pregnancy, has a limited role in the management of heterotopic pregnancy as one must try to preserve and protect the intrauterine pregnancy.
Differential diagnosis
Considerations include:
- ectopic pregnancy with an intra-uterine pseudogestational sac
- intra-uterine gestation with a haemorrhagic corpus luteum
-<p><strong>Heterotopic pregnancy</strong> is a rare situation when there is an intra-uterine and extra-uterine pregnancy occurring simultaneously.</p><h4>Epidemiology</h4><p>The estimated incidence in the general population is estimated at 1:30,000 (for a naturally conceived pregnancy <sup>7</sup>). The incidence among patients with assisted reproduction is higher and is thought to be around 1-3:100 <sup>2</sup>. Due to this, the overall incidence has increased over the years.</p><p>Heterotopic pregnancies have been diagnosed from 5-34 weeks of gestation with up to 70% diagnosed between 5-8 weeks of gestation, 20% between 9-10 weeks and only 10% after the 11<sup>th </sup>week <sup>6</sup>.</p><h4>Pathology</h4><h5>Risk factors</h5><p>Recognised risk factors predisposing to this condition include:</p><ul>- +<p><strong>Heterotopic pregnancy</strong> is a rare situation when there is an intra-uterine and extra-uterine (i.e. ectopic) pregnancy occurring simultaneously.</p><h4>Epidemiology</h4><p>The estimated incidence in the general population is estimated at 1:30,000 (for a naturally conceived pregnancy <sup>7</sup>). The incidence among patients with assisted reproduction is higher and is thought to be around 1-3:100 <sup>2</sup>. Due to this, the overall incidence has increased over the years.</p><p>Heterotopic pregnancies have been diagnosed from 5-34 weeks of gestation with up to 70% diagnosed between 5-8 weeks of gestation, 20% between 9-10 weeks and only 10% after the 11<sup>th </sup>week <sup>6</sup>.</p><h4>Pathology</h4><h5>Risk factors</h5><p>Recognised risk factors predisposing to this condition include:</p><ul>
-</ul><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Classically shows features or an <a href="/articles/intra-uterine-pregnancy">intra-uterine pregnancy </a>as well as an <a href="/articles/ectopic-pregnancy">ectopic pregnancy.</a></p><h4>Management</h4><p>An ultrasound-guided ablation or laparoscopic removal of the extra-uterine fetus can be considered in patients who have a known heterotopic pregnancy to permit the intrauterine pregnancy to continue normally.</p><p>Medical management, although used successfully for an ectopic pregnancy, has a limited role in the management of heterotopic pregnancy as one must try to preserve and protect the intrauterine pregnancy.</p><h4>Differential diagnosis</h4><h6>Considerations include:</h6><ul>- +</ul><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Classically shows features or an <a href="/articles/intra-uterine-pregnancy">intra-uterine pregnancy </a>as well as an <a href="/articles/ectopic-pregnancy">ectopic pregnancy.</a></p><h4>Treatment and prognosis</h4><p>An ultrasound-guided ablation or laparoscopic removal of the extra-uterine fetus can be considered in patients who have a known heterotopic pregnancy to permit the intrauterine pregnancy to continue normally.</p><p>Medical management, although used successfully for an ectopic pregnancy, has a limited role in the management of heterotopic pregnancy as one must try to preserve and protect the intrauterine pregnancy.</p><h4>Differential diagnosis</h4><p>Considerations include:</p><ul>
Image 2 Ultrasound ( create )
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