Heterotopic pregnancy: A seven-case report and review of literature

Heterotopic pregnancy also called combined pregnancy is a rare event combining intra- and extra-uterine pregnancies. Its frequency is increasing because of the increase of the assisted reproductive techniques and the infections of the upper genital tract. We report the management of seven cases of heterotopic pregnancies in Charles-Nicolle university hospital in Tunisia. The mean age was 31.7 years. The mean parity was 0.7. A history of appendicular peritonitis was reported in two cases. Pregnancy was obtained by IVF-ICSI in one case and after ovulation induction by clomifene citrate in four cases. Diagnosis was suspected at sonography in four cases. Treatment consisted in salpingectomy by laparoscopy in three cases and by laparotomy in one case. A conservative treatment was performed in two cases, once by laparoscopy and once by laparotomy. One patient had a potassium chloride injection inside the ectopic pregnancy under sonographic control. The feto-maternal prognosis was good in four cases. Two miscarriages were reported. (C) 2012 Elsevier Masson SAS. All rights reserved.