HETEROTOPIC PREGNANCY

• Heterotopic gestations describe the presence of both intrauterine and extrauterine gestations.
• Very rare, but increased incidence is reported as a direct result of multiembryo or gamete intrafallopian transfer (GIFT).
• Occurs in 1 – 2.9% of pregnancies after in vitro fertilization and embryo transfer.
• Sonographic demonstration of a normal intrauterine pregnancy is therefore not sufficient in either symptomatic or asymptomatic patients especially after assisted reproductive technology (ART). The adnexal and cul-de-sac should be thoroughly assessed.
• Site of ectopic implantation include; tubal, cornual, cervical, abdominal or ovarian.

REFERENCES

1. Yagel S, Hurwitz A, Ron M et.al. Ultrasonic detection of heterotopic pregnancy. A case report. J Clin Ultrasound 1983;11:502-505.
2. Simpson EL, Coleman BG, Sondheimer SJ et.al. In vitro fertilization and embryo transfer complicated by simultaneous ectopic and intrauterine twin gestations. J Ultrasound Med 1986;5:49-51.
3. Mattox JH, Kolb DJ, Goggin MW et.al. Heterotopic pregnancy diagnosed by endovaginal scanning. J Clin Ultrasound 1988;17:523-526.