gleichzeitige intrauterine und ektope Schwangerschaft
ähnliche Suchenheterotopic pregnancy
heterotopic ectopic pregnancy
heterotope Schwangerschaft
simultaneous intrauterine and ectopic pregnancy
concurrent intra uterine and extra uterine pregnancy
Simultaenous intra uterine and extra uterine pregnancy
Combined intra uterine and extra uterine pregnancy
siehe auchHeterotopic 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 ). The incidence among patients with assisted reproduction is higher and is thought to be around 1-3:100 . 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 11week .
Pathology
Risk factors
Recognized risk factors predisposing to this condition include:
- assisted reproductive techniques: multiple embryo transfer and ovulation induction
- 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 of an intra-uterine pregnancy as well as an ectopic pregnancy.
Treatment 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 hemorrhagic corpus luteum
Siehe auch:
