Termde Canlı Doğumla Sonuçlanan Spontan Heterotopik Gebelik

Öz

Amaç: Spontan siklusta gelişen ve term doğumla sonuçlanan heterotopik gebelik olgusunu sunmak. Olgu: 21 yaşındaki primigravida hasta acil servisimize amenore ,abdominal ağrı ve vajinal kanama şikayetiyle başvurdu.TVUSG'de 8 haftalık intrauterin canlı gebelik ve sol tubal yerleşimli ektopik gebelik gözlendi.Ektopik gebeliğe laparoskopik salpingostomi uygulandı ve intrauterin gebelik sorunsuz bir şekilde terme kadar takip edildi.Sezeryan ile canlı sağlıklı fetus doğurtuldu. Tartışma: Heterotopik gebelik nadir fakat hayati tehlike yaratabilen bir durumdur. Erken gebelikte abdominal ağrı ve vajinal kanama yakınması olan hastalarda heterotopik gebelik ihtimali ayırıcı tanıda düşünülmelidir. Anahtar kelimeler: Heterotopik Gebelik; Adneksiyal Kitle; Ektopik Gebelik.

Anahtar Kelimeler

• Heterotopik Gebelik; Adneksiyal Kitle; Ektopik Gebelik.

Spontaneous Heterotopic Pregnancy with Term Delivery of a Live Infant

Abstract

Objective: The aim of this report is to present a case of heterotopic pregnancy occurring in spontaneous cycle and ended up in term delivery. Case: A 21 year-old primigravida admitted to the emergency clinic with the complaints of amenorrhea, abdominal pain and vaginal bleeding. Transvaginal ultrasound scan showed an 8 weeks old live intrauterine pregnancy and a left tubal ectopic pregnancy. Laparoscopic salpingostomy was performed for ectopic pregnancy and intrauterine pregnancy was continued. The follow-up of the pregnancy was uneventful. A live healthy fetus was delivered by cesarean section at term. Conclusion: Spontaneous heterotopic pregnancy is a rare but life threatening condition and always must be considered in the differential diagnosis of patients with abdominal pain and vaginal bleeding during early pregnancy. Key words: Heterotopic Gestation; Adnexial Mass; Ectopic Pregnancy.

Keywords

• Heterotopic Gestation; Adnexial Mass; Ectopic Pregnancy.

Kaynakça

1. Bright DA, Gaupp FB. Heterotopic pregnancy: a reevaluation. J Am Board Fam Pract 1990;3:125-8.
2. Kolawole AO, Zayyan MS, Onwuhafua PI.Heterotopic gestation with subsequent live birth in a Jehovah s Witness: a case report. Niger J Clin Pract 2010;13(2):223-4.
3. Berliner I, Mesbah M, Zalud I, Maulik D. Heterotopic triplet pregnancy: report of a case with successful twin intrauterine gestation. J Reprod Med 1998;43:237-9.
4. Goldman G, Fisch B, Ovadia J, Tadir Y. Heterotopic pregnancy after assisted reproductive technologies. Obstet Gynecol Surv 1992;47:217-21.
5. Luo X, Lim CE, Huang C, Wu J, Wong WS, Cheng NC. Heterotopic pregnancy following in vitro fertilization and embryo transfer: 12 cases report. Arch Gynecol Obstet 2009;280(2):325-9.
6. Tal J, Haddad S, Gordon N, Timor-Tritsch I. Heterotopic pregnancy after ovulation induction and assisted reproductive Technologies: a literature review from 1971 to 1993. Fertil Steril 1996;66:1-12.
7. Barrenetxea G, Barinaga-Rementeria L, Lopez de Larruzea A, Agirregoikoa JA, Mandiola M, Carbonero K. Heterotopic pregnancy: two cases and a comparative review. Fertil Steril 2007;87(2):417.
8. Ocal P, Erkan S, Cepni I, Idil MH. Transvaginal ultrasound- guided aspiration and instillation of hyperosmolar glucose for treatment of unruptured tubal heterotopic pregnancy. Arch Gynecol Obstet 2007;276(3):281-3.

9. Lukaszuk K, Nakonieczny M, Wójcik D, Liss J, Preis K, Emerich J. Heterotopic pregnancy after in vitro fertilization. Przegl Lek 2006;63(4):239-41.