Heterotopic Pregnancy


Heterotopic Pregnancy, Compound Ectopic Pregnancy

  • Definitions
  1. Heterotopic Pregnancy (Compound Ectopic Pregnancy)
    1. Simultaneous ectopic AND intrauterine pregnancy
  • Epidemiology
  1. Associated with Assisted Reproductive Technologies (Infertility Treatment) in up to 1-3% of pregnancies
  2. Rare in spontaneous (non-ART) pregnancy: 1 in 30,000 pregnancies
  • Labs
  1. See Ectopic Pregnancy
  2. Quantitative bhCG
    1. May be misleading due to normal increases with the intrauterine pregnancy
  1. Identification of intrauterine pregnancy does not exclude Ectopic Pregnancy
  2. Ultrasound the Pelvis and Adnexa in addition to intrauterine cavity
  • Management
  1. See Ectopic Pregnancy
  2. Consult obstetrics
  3. Emergent surgery indications
    1. FAST Exam positive for intraabdominal free fluid
    2. Hemodynamic instability
    3. Significant exam findings (e.g. significant Abdominal Pain)
  • References
  1. Gallo, Suyama and Snook (2020) Crit Dec Emerg Med 34(10): 3-7