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Heterotopic pregnancy and amniotic embolism: a case report
Gabriella Soecki1, Elisa Carolina Hlatchuk2, Caroline Thereza Raymundo2
1Medicine Student, Federal University of Paraná, Curitiba, Paraná, Brazil. gabriellasoecki@gmail.com.
BMC Pregnancy and Childbirth
|November 15, 2024
Summary
This case report details a rare pancreatic heterotopic pregnancy that resulted in amniotic embolism and disseminated intravascular coagulation, leading to an unfavorable maternal outcome. Early suspicion of heterotopic pregnancy is crucial for timely diagnosis and intervention.
Area of Science:
- Reproductive Medicine
- Obstetrics & Gynecology
- Pathology
Background:
- Heterotopic pregnancy and amniotic embolism are rare, challenging diagnoses.
- No prior literature describes heterotopic pregnancy associated with amniotic embolism.
Observation:
- A 20-year-old woman presented with abdominal pain and elevated lipase, initially suspected as hyperemesis gravidarum or pancreatitis.
- Despite initial stabilization, she developed spontaneous abortion, respiratory failure, and cardiorespiratory arrest.
- Necropsy revealed a pancreatic tail heterotopic pregnancy, amniotic embolism, and disseminated intravascular coagulation.
Findings:
- This is the first reported case of pancreatic heterotopic pregnancy leading to amniotic embolism.
- The pancreatic location of the ectopic pregnancy is implicated in the introduction of fetal antigens and amniotic fluid into maternal circulation.
- Amniotic embolism resulted in disseminated intravascular coagulation and a fatal maternal outcome.
Implications:
- Obstetricians must consider heterotopic pregnancy in acute abdominal presentations.
- Laparoscopy is the gold standard for diagnosing heterotopic pregnancy.
- This case highlights the potential for rare pregnancy complications to have severe, life-threatening consequences.
