April 23rd, 2017

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Title:
Heterotopic Triplet Pregnancy in Gonadotropin Stimulation Cycle: A Case Report
Authors:  Carrie K. Riestenberg, M.D., Mark D. Nixon, M.D., Ph.D., Isiah D. Harris, M.D., and Lisa Farah-Eways, M.D.
 
BACKGROUND: Heterotopic pregnancy is defined as the simultaneous presence of 2 or more pregnancies at different implantation sites, most commonly one intrauterine and one ectopic. Triplet heterotopic pregnancy refers to the presence of specifically 3 concurrent gestations with at least 1 being abnormally implanted. Heterotopic pregnancy is a potentially life-threatening condition that requires thorough diagnostic workup and prompt intervention.

CASE: We report the fourth case of triplet heterotopic pregnancy after ovarian stimulation with gonadotropins. A 24-year-old woman, G0, presented at 6 weeks of gestation with bilateral tubal ectopic pregnancies and a nonviable intrauterine pregnancy (IUP) after gonadotropin stimulation cycle. Bilateral tubal pregnancies were removed laparoscopically and the nonviable IUP via dilation and curettage.

CONCLUSION: Although rare, heterotopic pregnancy of 2 or more gestations must be kept in mind when managing patients undergoing treatment with ART. Careful examination of bilateral adnexa and consideration of uterine sampling at the time of surgery for ectopic pregnancy is advisable, even for patients with few or no risk factors.
Keywords:  assisted reproductive techniques; ectopic pregnancy; extrauterine pregnancy; gonadotropin; multiple pregnancy; ovarian stimulation; pregnancy, heterotopic; pregnancy, triplet; reproductive technology, assisted; tubal pregnancy
   
   
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