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Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care
Heterotopic pregnancy is a rare, difficult to diagnose and life-threatening pathology, which requires timely decisions made by an experienced multidisciplinary team. In this type of multiple pregnancy there are both intrauterine and ectopic pregnancies present. Its incidence increases in pregnancies...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625167/ https://www.ncbi.nlm.nih.gov/pubmed/34833425 http://dx.doi.org/10.3390/medicina57111207 |
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author | Didziokaite, Gabija Vitaityte, Monika Zykute, Gerda Paliulyte, Virginija Samuilis, Arturas |
author_facet | Didziokaite, Gabija Vitaityte, Monika Zykute, Gerda Paliulyte, Virginija Samuilis, Arturas |
author_sort | Didziokaite, Gabija |
collection | PubMed |
description | Heterotopic pregnancy is a rare, difficult to diagnose and life-threatening pathology, which requires timely decisions made by an experienced multidisciplinary team. In this type of multiple pregnancy there are both intrauterine and ectopic pregnancies present. Its incidence increases in pregnancies conceived by assisted reproductive technology or in pregnancies with ovulation induction. This article presents an angular heterotopic pregnancy case in a 34-year-old multigravida. The patient was admitted on the 14th week of gestation due to abdominal pain on the left side with suspicion of heterotopic pregnancy. Transabdominal ultrasound and magnetic resonance imaging (MRI) were performed to confirm the diagnosis of heterotopic angular pregnancy in the left cornu of the uterus. Multidisciplinary team made a decision to keep monitoring the growth of both pregnancies by ultrasound while maternal vitals were stable. Due to intensifying abdominal pain, diagnostic laparoscopy was performed. No signs of uterine rupture were observed, and no additional surgical procedures were performed. Maternal status and ultrasonographic findings were closely monitored. The mass in the left cornu of the uterus did not change significantly and the fetal growth of the intrauterine pregnancy matched its gestational age throughout pregnancy. At the 41st week of gestation, a healthy female neonate was born via spontaneous vaginal delivery. The incidence rate of heterotopic pregnancy tends to grow due to an increased number of pregnancies after assisted reproductive technology and ovulation induction. It is important to always assess the risk factors. The main methods for diagnosing heterotopic pregnancies are ultrasonography and MRI. The main management tactics for heterotopic pregnancy include expectant management as well as surgical or medical termination of the ectopic pregnancy. Expectant management may be chosen as an option only in a limited number of cases, if the clinical situation meets the specific criteria. When applicable, expectant management may reduce the frequency of unnecessary interventions and help to prevent patients from its complications. |
format | Online Article Text |
id | pubmed-8625167 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-86251672021-11-27 Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care Didziokaite, Gabija Vitaityte, Monika Zykute, Gerda Paliulyte, Virginija Samuilis, Arturas Medicina (Kaunas) Case Report Heterotopic pregnancy is a rare, difficult to diagnose and life-threatening pathology, which requires timely decisions made by an experienced multidisciplinary team. In this type of multiple pregnancy there are both intrauterine and ectopic pregnancies present. Its incidence increases in pregnancies conceived by assisted reproductive technology or in pregnancies with ovulation induction. This article presents an angular heterotopic pregnancy case in a 34-year-old multigravida. The patient was admitted on the 14th week of gestation due to abdominal pain on the left side with suspicion of heterotopic pregnancy. Transabdominal ultrasound and magnetic resonance imaging (MRI) were performed to confirm the diagnosis of heterotopic angular pregnancy in the left cornu of the uterus. Multidisciplinary team made a decision to keep monitoring the growth of both pregnancies by ultrasound while maternal vitals were stable. Due to intensifying abdominal pain, diagnostic laparoscopy was performed. No signs of uterine rupture were observed, and no additional surgical procedures were performed. Maternal status and ultrasonographic findings were closely monitored. The mass in the left cornu of the uterus did not change significantly and the fetal growth of the intrauterine pregnancy matched its gestational age throughout pregnancy. At the 41st week of gestation, a healthy female neonate was born via spontaneous vaginal delivery. The incidence rate of heterotopic pregnancy tends to grow due to an increased number of pregnancies after assisted reproductive technology and ovulation induction. It is important to always assess the risk factors. The main methods for diagnosing heterotopic pregnancies are ultrasonography and MRI. The main management tactics for heterotopic pregnancy include expectant management as well as surgical or medical termination of the ectopic pregnancy. Expectant management may be chosen as an option only in a limited number of cases, if the clinical situation meets the specific criteria. When applicable, expectant management may reduce the frequency of unnecessary interventions and help to prevent patients from its complications. MDPI 2021-11-05 /pmc/articles/PMC8625167/ /pubmed/34833425 http://dx.doi.org/10.3390/medicina57111207 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Didziokaite, Gabija Vitaityte, Monika Zykute, Gerda Paliulyte, Virginija Samuilis, Arturas Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care |
title | Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care |
title_full | Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care |
title_fullStr | Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care |
title_full_unstemmed | Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care |
title_short | Angular Heterotopic Pregnancy: Successful Differential Diagnosis, Expectant Management and Postpartum Care |
title_sort | angular heterotopic pregnancy: successful differential diagnosis, expectant management and postpartum care |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625167/ https://www.ncbi.nlm.nih.gov/pubmed/34833425 http://dx.doi.org/10.3390/medicina57111207 |
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