eISSN: 2299-0038
ISSN: 1643-8876
Menopause Review/Przegląd Menopauzalny
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4/2021
vol. 20
 
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abstract:
Case report

Early diagnosis and surgical management of heterotopic pregnancy allows us to save the intrauterine pregnancy

Gaspare Cucinella
1
,
Giuseppe Gullo
1
,
Andrea Etrusco
1
,
Erika Dolce
2
,
Silvia Culmone
1
,
Giovanni Buzzaccarini
3

  1. Obstetrics and Gynaecology Department, Villa Sofia Cervello Hospital, University of Palermo, Italy
  2. Family Psychotherapy Academy, Palermo, Italy
  3. Department of Women’s and Children’s Health, Gynaecology and Obstetrics Clinic, University of Padua, Italy
Menopause Rev 2021; 20(4): 222-225
DOI: https://doi.org/10.5114/pm.2021.111277
Online publish date: 2021/12/06
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Heterotopic pregnancy is a rare but intriguing disease, which poses a high risk for pregnant women and for intrauterine pregnancy. Clinically, it is mainly characterized by pain and vaginal bleeding. b-hCG serum dosage is used to detect the pregnancy, but transvaginal ultrasound is needed to diagnose heterotopic pregnancy. From all the risk factors, the assisted reproductive treatments represent the most important, especially when multiple embryos are transferred. Patients with a heterotopic pregnancy are at risk of having a spontaneous or medically induced abortion, and for this reason appropriate and tailored treatment should be considered, pursuing the optimal risk/benefit ratio. Although conservative treatments are available in the case of only extrauterine pregnancy, such as methotrexate, often the laparoscopic approach seems unavoidable in heterotopic pregnancy. To preserve the intrauterine pregnancy, a conservative treatment is remarkable, both salpingotomy or salpingostomy. In this case report, we present a successful laparoscopic treatment of an extrauterine pregnancy with the prosecution of the intrauterine pregnancy up to the third trimester. In particular, a 25-year-old girl referred to the Villa Sofia Cervello Hospital complaining of abdominopelvic pain and vaginal bleeding for 2 days. The salpingectomy approach was performed, and every anatomical piece was sent for histopathology.
keywords:

heterotopic pregnancy, salpingectomy, laparoscopy, pregnancy-sparing
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