F. Kobayashi et al., SPONTANEOUS CONCEPTION AND INTRAUTERINE PREGNANCY IN A SYMPTOMATIC MISSED ABORTION OF ECTOPIC PREGNANCY CONCEIVED IN THE PREVIOUS CYCLE, Human reproduction, 11(6), 1996, pp. 1347-1349
We encountered a rare case of combined intrauterine and extrauterine p
regnancy that occurred following separate spontaneous ovulations. A 33
year old woman visited our hospital with the chief complaint of abdom
inal pain on April 16, 1993, Her last menstruation was from March 23 f
or 6 days, However, the urinary human chorionic gonadotrophin (HCG) on
April 19 was 1024 IU/l. Pelvic examination and ultrasonography indica
ted an extrauterine pregnancy, which was confirmed by laparotomy and h
istological identification of trophoblast cells, The urinary HCG conce
ntration markedly decreased after the operation, However, the HCG leve
l increased again on the fifth postoperative day, and a gestational sa
c (11 mm) was identified in the uterine cavity on the 11th post-operat
ive day, indicating that this intrauterine pregnancy was established f
ollowing spontaneous ovulation which occurred before the removal of th
e extrauterine pregnancy. This case indicates that a combined pregnanc
y can occur not only after simultaneous multiple ovulations but also a
fter the separate spontaneous ovulations.