Combined extra- and intra-uterine pregnancies. A report of 3 cases

Three cases of combined extra- and intra-uterine pregnancies are described. In 2 cases the diagnosis was made during laparotomy for ectopic pregnancy continued undisturbed. The third case proved to be a secondary abdominal pregnancy discovered 4 weeks after evacuation for abortion. The possibility of heterotopic pregnancy is more likely to occur in population groups with a high incidence of pelvic infections and in patients who receive ovulation-induction medication. Over the last decades the fetal and maternal prognosis has greatly improved because of better surgical and diagnostic techniques, efficient treatment of hypovolaemic shock and safer anaesthesia. Routine ultrasonographic examination in the first trimester of pregnancy would make early recognition of heterotopic pregnancy possible.