LAPAROSCOPIC SURGERY FOR HETEROTOPIC PREGNANCIES - A CASE-REPORT AND A BRIEF REVIEW

A heterotopic pregnancy is in effect a multiple pregnancy with one or more intrauterine pregnancies coexisting with an ectopic pregnancy and is rarely spontaneous. With the increasing popularity of ovulation in duction performed during assisted reproductive techniques, it will not be surprising to observe that this phenomenon has increased significa ntly. However, diagnosis is often delayed because of its rarity and di fficulty. We report a case of a woman with a viable intrauterine pregn ancy who had a complication of ovarian hyper-stimulation syndrome seco ndary to ovulation induction following in vitro fertilization and embr yo transfer, but who, during hospitalization, presented with clinicall y progressive abdominal pain. An unruptured ectopic pregnancy of the r ight fallopian tube was diagnosed accidentally by laparoscopy and lapa roscopic salpingectomy was immediately performed. Post-operative follo w-up revealed that the intrauterine pregnancy continued normally. She delivered a normal female baby at 38 weeks of gestation. The promising neonatal outcome might suggest that laparoscopy might be safely perfo rmed to aid differential diagnosis in an uncertain condition during pr egnancy: therefore, laparoscopic surgery might be an appropriate metho d to manage some carefully selected patients with HP. A brief review o f the published literature on the role of laparoscopy in the diagnosis and management of heterotopic pregnancy is given. (C) 1998 Elsevier S cience ireland Ltd. All rights reserved.