Diagnostic and therapeutic algorithm of heterotopic pregnancy
Authors:
R. Vavrušová; R. Hudeček; B. Kuřecová; P. Ventruba
Authors place of work:
Gynekologicko-porodnická klinika LF MU a FN Brno
Published in the journal:
Prakt Gyn 2007; 11(2): 66-69
Summary
Heterotopic pregnancy is defined as concomitant incidence of intrauterine and ectopic pregnancy. The most often referred rate of incidence of heterotopic pregnancy ranges between 1 per 20,000 and 1 per 30,000 cases of intrauterine pregnancy. However, progress in assisted reproduction has caused dramatic increase in the risk of heterotopic pregnancy, especially in association with in vitro fertilisation (IVF), embryotransfer (ET) of more embryos and intrauterine insemination (IUI). The incidence of heterotopic pregnancy within assisted reproduction ranges between 0.75 and 2.9 %.
Objective:
Presenting of a diagnostic and therapeutic algorithm for heterotopic pregnancy using 2 casuistics and providing a self-contained overview of the above issue. Material and method: 2 reference heterotopic pregnancy casuistics following IVF/ET with different clinical courses; diagnostic algorithm, surgical treatment and subsequent release of patients.
Conclusion:
Attention should be given to the risk of heterotopic pregnancy in all incipient pregnancies following IVF/ET and intrauterine insemination. In case of suspected heterotopic pregnancy, the patient should be hospitalised, and ultrasound examination and monitoring of serum hCG level dynamics should be performed. Timely surgical intervention is the necessary condition for excluding the risk of posthemorrhagic shock due to tube rupture. In addition, early intervention helps to sustain and carry forward intrauterine pregnancy.
Key words:
heterotopic pregnancy – in vitro fertilisation – intrauterine insemination – embryotransfer
Zdroje
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Štítky
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineČlánok vyšiel v časopise
Practical Gynecology
2007 Číslo 2
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