Pregnancy outcomes of heterotopic pregnancy

Lee, Hee Suk; Kim, Joo Myung; Yoo, Ji Hee; Yook, Ji Hyung; Kim, Mi La; Yoon, Jae Bum; Joo, Kwan Young; Jun, Jong Young; Han, Ho Won

Abstract

OBJECTIVE
The purpose of this study was to evaluate the pregnancy outcomes of heterotopic pregnancy.
METHODS
Retrospective analysis was done in 24 patients who were diagnosed as heterotopic pregnancy between January 2000 and April 2008. Patients' characteristics, risk factors, treatment methods and pregnancy outcomes were evaluated.
RESULTS
A total of 24 patients were diagnosed as heterotopic pregnancy, all of these had undergone assisted reproductive technique. The mean age was 31.5 years and the mean gestational age at diagnosis was about 8 weeks. The most common etiology of infertility was tubal factor (54.2%). Four (16.7%) of the women had undergone ovulation induction, eighteen (75%) had undergone in vitro fertilization, but 2 patients (8.3%) had undergone assisted reproductive technique at other hospital and we didn't know the exact method. The most common of ectopic site was tube (75%), and 50% of ectopic sites were ruptured status at diagnosis. Three (12.5%) of 24 patients were diagnosed ectopic pregnancy after dilatation and evacuation due to missed abortion, 4 (16.7%) were diagnosed ectopic pregnancy and missed abortion, and 17 (70.8%) were diagnosed ectopic pregnancy and living intrauterine pregnancy at the time of diagnosis. Laparotomy was done in 3 patients (12.5%) and laparoscopy was done in 21 patients (87.5%). Among 17 patients who had normal intrauterine pregnancy, 12 (70.6%) delivered singletones, 2 (11.8%) delivered twins, but 3 (17.6%) patients were lost follow up.
CONCLUSION
Heterotopic pregnancy should be considered in pregnant woman with abdominal pain or vaginal bleeding, although confirmed normal intrauterine pregnancy using ultrasonography at early gestational age, especially if the woman have treatment history for infertility. And early diagnosis and proper management are important.