Heterotopic pregnancy: report of three cases

Heterotopic pregnancy, defined as concomitant intrauterine and ectopic pregnancy, is a rare event. Assisted reproductive technologies have led to an increase in the number of heterotopic pregnancies.

From 1997 to 1999 three cases of heterotopic pregnancies were referred to the gynecological unit of the hospital of St. Pölten. The condition was diagnosed at 7, 8 and 12 weeks of gestation, respectively. Two patients had undergone assisted reproductive technologies and former pelvic surgery for tubal pregnancy. Two patients had intrauterine singleton pregnancies and one patient had an intrauterine twin pregnancy. In all cases the ectopic site presented as a ruptured tubal pregnancy and the treatment consisted of laparoscopic salpingectomy.

In all patients the postoperative course was uneventful and the intrauterine pregnancy progressed. In one case recurrent preterm labor led to vaginal delivery at 33 weeks of pregnancy. In the case of twin pregnancy, a planned cesarean section was performed at 37 weeks of gestation. One patient delivered at term. All newborns were healthy.

Knowledge of heterotopic pregnancy and understanding the epidemiological risk factors underlying this condition are important for early diagnosis with the aim of improving therapy and clinical outcome.