Heterotopic Pregnancy with Spontaneous Vaginal Delivery at 36 Weeks and Laparotomy at Term - A Case Report

Chisara C Umezurike, Paul A Feyi-Waboso


Heterotopic pregnancy, although rare, is occurring more frequently because of an increase in genital infection and the escalating use of new reproductive technologies in infertility patients. The case of a 30-year-old para 2+1prophetess is presented. She had a spontaneous vaginal delivery at term. Persistent abdominal pain and distension led to suspicion of heterotopic pregnancy. This was confirmed by ultrasonography. Laparotomy revealed a macerated fetus in the peritoneal cavity. The purpose of this report is to sensitise practitioners about the reality and existence of the condition. (Afr J Reprod Health 2005; 9[1]: 162-165)


Keywords: Infertility, infection, laparotomy, pregnancy, heterotopic

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Pisarka MD, Carson SA and Buster JE. Ectopic pregnancy. The Lancet 1998; 135: 1115-1120.

Grudzinkas JG Miscarriage, ectopic pregnancy and trophoblastic disease. In: Edmonds DK. Dewhurst's Textbook of Obstetrics and Gynaecology for Postgraduates. 6th Edition. Blackwell Science Ltd., 1999, 61-75.

Ludwig M, Kaisi M, Bauer O and Diedrich K. Heterotopic pregnancy in a spontaneous cycle: do not forget about it. Eur J Ostet Gynecol Reprod Biol 1999; 87: 91-103.

Habana FD, Dorcas A, Giraldo JL and Jones EE. Cornual heterotopic pregnancy: contemporary management options. Am J Obstet Gynecol 2000; 182: 1264-70.

Glassner MI, Aron E and Eskin BA. Ovulation induction with cloniphene and the rise in heterotopic pregnancies.A report of two cases. J Reprod Med 1990; 35: 175.

Archibong EI and Etuk J. Heterotopic pregnancy following induction of ovulation: a case report. Trop J Obstet Gynecol 2002; 19(2): 115-116.

Sayin NC and Yardim T. Live birth of healthy twins after a heterotopic tubal and intrauterine twin pregnancy in a woman who was stimulated with clomiphene citrate. Case report. Fert Steril 2003; 80(5): 1265-1267.

Nair P and Chauhan M. Heterotopic pregnancy (triplets) following in vitro fertilization: case report. Arch Gynecol Obstet 1999;

: 84-85.

Klipstein S and Oskowitz SP. Bilateral ectopic pregnancy after transfer of two embryos. Fertil Steril 2000; 74: 887-888.

Taj J Haddad S, Gordon N and Timor-Ttritsch I. Heterotopic pregnancy after ovulation induction and assisted reproductive technologies: literature review from 1971 to 1993. Fertil Steril 1996; 66: 1-12.

Laghzaoui Boukaidi M, Bouhya S, Sefrioui O, Bennani O, Hermas S and Aderdour M. Heterotopic pregnancies: 8 cases. Gynecol Obstet Fertil 2002; 30(3): 218-223.

Gazvani MR. Modern management of ectopic pregnancy. Br J Hosp Med 1996; 56(11): 597-599.

Ifenne DI, Shittu SO and Mandara MU. Advanced abdominal pregnancy with a live baby. Trop J Obstet Gynaecol 1999; 16(1):


Ekele BA, Audu LR and Oyetunji JA. Combined extrauterine and intrauterine pregnancy. Trop J Obstet Gynaecol 1999; 16(1):


Varma R, Mascarenhas L and James D. Successful outcome of abdominal pregnancy with exclusive omental insertion. Ultrasound Obstet Gynecol 2003; 21: 192-194.

Babic D, Colic G and Mrden D. Complications after surgery for abdominal pregnancy due to a retained placenta. Jugosl Giecol Opstet 1983; 23: 93-94.

Atrash HK, Friede A and Hogue CJ. Abdominal pregnancy in the United States: frequency and maternal mortality. Obstet Gynecol 1987; 69: 333-337.

Costa SD, Presley J and Bastert G. Advanced abdominal pregnancy. Obstet Gynecol Surv 1991; 46: 515-525.

Hudson CN and Howkins J. Operative treatment of ectopic pregnancy. In: Hudson CN and Howkins J. Shaw's Textbook of Operative Gynaecology. 5th Edition Churchhill Livingstone PVT Ltd, 1993, 237-244.


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