Heterotopic Pregnancy

Solwayo Ngwenya*

Heterotopic Pregnancy

Heterotopic pregnancy is a rare gynaecological condition whereby there is a presence
of an intrauterine pregnancy and extrauterine pregnancy at the same time.

It was first defined by Duverney in 1708 as an autopsy finding in a patient who had died of a ruptured ectopic pregnancy and had an intrauterine pregnancy.

Rarely an intrauterine twin gestation can co-exist with a heterotopic pregnancy or vice versa.
Higher order heterotopic gestations are extremely rare. This condition may cause diagnostic difficulties and the patient may collapse and die during investigations.

Those occurring after fertility treatments may face ethical and emotional
dilemma of having to lose one of their babies. It is a rare life-threatening condition that very
few clinicians would come across during their careers.

It is therefore an important clinical condition, hence the need to bring
the subject prominence through a review article like this one.

The reported incidence of heterotopic pregnancy in a spontaneous natural cycle is in 30,000.
This is indeed very rare that some clinicians may never come across it during their careers.

This poses a danger to the mother and the intrauterine pregnancy
as very few clinicians will consider this diagnosis until it is too late.

It is mostly likely to be outside the list of initial differential diagnoses.

There is a direct increase in the incidence related to the number of
embryos being transferred during in vitro fertilisation.

The incidence has increased to 2.9%1 with ovulation induction and to 1% with
assisted reproductive techniques. Couples undergoing such processes must be
fully counselled on these risks.

Gynecol Obstet Res Open J. 2015; 2(4): 89-92. doi: 10.17140/GOROJ-2-120