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Heterotopic Pregnancy: Diagnosis and Pitfall in Ultrasonography

Heterotopic pregnancy (HP) is the coexistence of extrauterine and intrauterine pregnancies. This case is rare, difficult to diagnose, and threatening if left untreated. Incidental rate is estimated 1 in 30,000 spontaneous pregnancies and higher in assisted reproductive techniques. HP is often missed...

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Autores principales: Harzif, Achmad Kemal, Hyaswicaksono, Purnomo, Kurniawan, Riyan Hari, Wiweko, Budi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968611/
https://www.ncbi.nlm.nih.gov/pubmed/33747776
http://dx.doi.org/10.4103/GMIT.GMIT_92_19
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author Harzif, Achmad Kemal
Hyaswicaksono, Purnomo
Kurniawan, Riyan Hari
Wiweko, Budi
author_facet Harzif, Achmad Kemal
Hyaswicaksono, Purnomo
Kurniawan, Riyan Hari
Wiweko, Budi
author_sort Harzif, Achmad Kemal
collection PubMed
description Heterotopic pregnancy (HP) is the coexistence of extrauterine and intrauterine pregnancies. This case is rare, difficult to diagnose, and threatening if left untreated. Incidental rate is estimated 1 in 30,000 spontaneous pregnancies and higher in assisted reproductive techniques. HP is often missed because of the detection of intrauterine sacs; therefore, comprehensive and systematic ultrasonography (USG) is needed, especially when there is ectopic pregnancy suspicion or when there is free fluid in the pelvis. A 46-year nulligravida with 13-year primary infertility history underwent frozen embryo transfer process with positive beta-human chorionic gonadotropin 2 weeks after the procedure. Clinical pregnancy is expressed by gestational sac findings at 6-week gestation. Two weeks later, she complained of lower right abdominal pain accompanied by spots from the birth canal. USG showed intrauterine pregnancy and sac appropriate to 8-week gestation and adnexal mass accompanied by a ring of fire image. The patient underwent right salpingectomy, recovered well, and continued her pregnancy. In vitro fertilization is the main risk factor for multiple and ectopic pregnancies. Clinical manifestations are similar to pregnancy loss or ectopic pregnancy. Specific risk factor must be acknowledged by the physician prior initial examination to rule out HP. Transvaginal ultrasound is useful in making the diagnosis of HP, especially in early pregnancy.
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spelling pubmed-79686112021-03-19 Heterotopic Pregnancy: Diagnosis and Pitfall in Ultrasonography Harzif, Achmad Kemal Hyaswicaksono, Purnomo Kurniawan, Riyan Hari Wiweko, Budi Gynecol Minim Invasive Ther Case Report Heterotopic pregnancy (HP) is the coexistence of extrauterine and intrauterine pregnancies. This case is rare, difficult to diagnose, and threatening if left untreated. Incidental rate is estimated 1 in 30,000 spontaneous pregnancies and higher in assisted reproductive techniques. HP is often missed because of the detection of intrauterine sacs; therefore, comprehensive and systematic ultrasonography (USG) is needed, especially when there is ectopic pregnancy suspicion or when there is free fluid in the pelvis. A 46-year nulligravida with 13-year primary infertility history underwent frozen embryo transfer process with positive beta-human chorionic gonadotropin 2 weeks after the procedure. Clinical pregnancy is expressed by gestational sac findings at 6-week gestation. Two weeks later, she complained of lower right abdominal pain accompanied by spots from the birth canal. USG showed intrauterine pregnancy and sac appropriate to 8-week gestation and adnexal mass accompanied by a ring of fire image. The patient underwent right salpingectomy, recovered well, and continued her pregnancy. In vitro fertilization is the main risk factor for multiple and ectopic pregnancies. Clinical manifestations are similar to pregnancy loss or ectopic pregnancy. Specific risk factor must be acknowledged by the physician prior initial examination to rule out HP. Transvaginal ultrasound is useful in making the diagnosis of HP, especially in early pregnancy. Wolters Kluwer - Medknow 2021-01-30 /pmc/articles/PMC7968611/ /pubmed/33747776 http://dx.doi.org/10.4103/GMIT.GMIT_92_19 Text en Copyright: © 2021 Gynecology and Minimally Invasive Therapy http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Case Report
Harzif, Achmad Kemal
Hyaswicaksono, Purnomo
Kurniawan, Riyan Hari
Wiweko, Budi
Heterotopic Pregnancy: Diagnosis and Pitfall in Ultrasonography
title Heterotopic Pregnancy: Diagnosis and Pitfall in Ultrasonography
title_full Heterotopic Pregnancy: Diagnosis and Pitfall in Ultrasonography
title_fullStr Heterotopic Pregnancy: Diagnosis and Pitfall in Ultrasonography
title_full_unstemmed Heterotopic Pregnancy: Diagnosis and Pitfall in Ultrasonography
title_short Heterotopic Pregnancy: Diagnosis and Pitfall in Ultrasonography
title_sort heterotopic pregnancy: diagnosis and pitfall in ultrasonography
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7968611/
https://www.ncbi.nlm.nih.gov/pubmed/33747776
http://dx.doi.org/10.4103/GMIT.GMIT_92_19
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