Ruptured Tubal Triplet Heterotopic Pregnancy After in Vitro Fertilisation: A Case Report Mehmet A. OSMANAĞAOĞLU, Murat AKSOY, F. Ceylan İLHAN, Recep ERİN Trabzon, Turkey To analyse the incidence, diagnostic and therapeutic management of heterotopic pregnancy following in vitro fertilisation (IVF). We present a case who had a ruptured left tubal heterotopic triplet pregnancy at nine weeks of gestation following in vitro fertilisation. A 47-year-old pregnant woman who conceived following IVF-ET transfer was referred to our emergency unit with a suspicion of stomach perforation at 9 weeks’ gestation. on physical examination she had severe abdominal pain and distension. Her blood pressure 130/70 mmHg and pulse rate 96 beats/min. Pelvic examination showed tenderness on movement of the cervix and a slightly enlarged uterus. Her hemoglobin was 9.4 mg/dl. Transabdominal ultrasound examination showed an intrauterin viable twin pregnancy. A third gestationel sac at the left cornual area of which diameter was 23 mm was also seen. Massive amount of fluid was detected in perihepatic, perispleenic, and the cul-de-sac area and also between bowels. Based on these findings a ruptured heterotopic pregnancy was suspected and emergency laparotomy was performed. At laparotomy, there was 800 ml of hemoperitoneum. There was a 2-3 cm ruptured isthmic ectopic pregnancy in the left tube. A left total salpingectomy was performed. Postoperative recovery was uneventful and the patient was discharged on postoperative day 3 in good condition. She was following up in the antenatal unit and the twin pregnancy is progressing normally. Heterotopic pregnancies are rare but life-threatening conditions, therefore it should be kept it in mind when a pregnant woman who underwent IVF-ET, presents low abdominal pain. Key Words: Heterotopic pregnancy, In vitro fertilisation
Ruptured Tubal Triplet Heterotopic Pregnancy After in Vitro Fertilisation: A Case Report Mehmet A. OSMANAĞAOĞLU, Murat AKSOY, F. Ceylan İLHAN, Recep ERİN Trabzon, Turkey
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