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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
Rivista di Medicina Interna e Farmacologia
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2014 Ottobre;173(10):533-7
Diagnosis and therapy of heterotopic interstitial pregnancy with progression of intrauterine twin
Croce P., Panzeri L., Perotti D., Zanchi S. M.
U.O. di Ostetricia e Ginecologia 2, Dipartimento Materno-Infantile, A.O. Lodi, Lodi, Italia
The aim of this study was to report our experience with the diagnosis and therapy of a heterotopic interstitial pregnancy after intracytoplasmatic sperm injection (ICSI) and the transfer of two embryos. The patient had had a previous left salpingectomy due to an ectopic pregnancy and another diagnostic laparoscopy during which the left tubal was completely removed. Laparoscopic surgery was performed. We diagnosed an interstitial pregnancy measuring 35-40 mm in diameter. The gestational sac was aspirated after performing a small incision on the uterine wall. Incision closure and hemostasis were achieved by both electrocoagulation and the application of three staples. Intrauterine embryo was preserved. The pregnancy developed uneventfully up to 37 weeks’ gestation. As recommended by the majority of the authors, the patient delivered by cesarean section a baby weighing 2570 g. Heterotopic pregnancy has an increased incidence in the case of FIV-ET (in vitro fertilization- embryo transfer). For this reason, women undergoing assisted reproductive techniques must be carefully considered, in order to achieve an early US diagnosis at 5-6 weeks’ gestation. A prompt diagnosis and the laparoscopic surgery allow both the avoidance of severe hemorragic complications and the continuation of the intrauterine pregnancy, with the crowning achievement of the many expectations and sacrifices endured by the parents.