A Case of Heterotopic Pregnancy after Tubal Reanastomosis

Kim, Jin Ho; Hong, Sun Hee; Han, Yun Jong; La, Hai Young; Kang, Chang Seong; An, Ki Bum; Wang, Young Mee; Park, Jong Kyou

Abstract

Heterotopic pregnancy is the coexistence of intrauterine and extrauterine pregnancy. It is a rare obstetrical phenomenon with an incidence rate about 0.003%. The risk factors of heterotopic pregnancy are IUD, PID, endometriosis, tubal surgery, etc resulting in functional and anatomical injury to tubes. Recently, the wide use of ovulation induction and in vitro fertilization has increased the incidence rate. The clinical manifestation are low abdominal pain, adnexal mass, peritoneal irritation signs, vaginal bleeding, etc. Early detecion of heterotopic pregnancy is very difficult. However, recently, due to development of pelviscopy, ultrasonogram and other diagnostic procedures, the diagnostic rate has increased.Because of the high maternal morbidity and mortality resulted from intraabdominal bleeding after rupture of ectopic pregnacy, immediate termination of ectopic pregnancy is required usually by operative methods. We experienced a case of heterotopic pregnancy after tubal reanastomosis and report this case with a brief review of literatures.