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Human Reproduction, Vol. 17, No. 5, 1363-1366, May 2002
© 2002 European Society of Human Reproduction and Embryology

Heterotopic triplet pregnancy: report of a case with bilateral tubal pregnancy and an intrauterine pregnancy: Case report

Hun-Shan Pan, Jesse Chuang, Su-Fang Chiu, Bih-Chwen Hsieh, Yu-Hung Lin, Yieh-Loong Tsai, Shih-Chia Huang, Mei-Ling Hsieh, Chin-Yu Chen and Jiann-Loung Hwang,1

Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shih Lin District, Taipei, Taiwan

The first report of an ectopic pregnancy following IVF was published in 1976, and since then heterotopic pregnancies (HPs) have been reported at an increasing rate. Although cases of the co-existence of a bilateral tubal and an intrauterine pregnancy following IVF–embryo transfer have been reported, a case of heterotopic triplet pregnancy caused by unilateral tubal embryo transfer has not yet been published in the literature. Here we report on a 38-year-old women (gravida 3, para 1) with a history of infertility who presented to our infertility clinic for evaluation. Hysterosalpingography revealed bilaterally patent Fallopian tubes and stricture of the cervical canal. She conceived after receiving HMG combined with pure FSH, followed by IVF–tubal embryo transfer. Four embryos were replaced into the right tube. Approximately 5 weeks after tubal embryo transfer, the patient presented with lower abdominal tenderness and shock due to internal bleeding. She underwent an emergency laparotomy under the impression of HP. Bilateral tubal pregnancy with right tubal rupture was noted during the operation. The post-operative course was uneventful. Early intervention and thorough inspection of the peritoneal cavity in patients with haemodynamic instability can prevent jeopardizing the life of the mother as well as the ongoing pregnancy.

Key words: bilateral tubal pregnancy/heterotopic pregnancy/IVF-tubal embryo transfer/triplet pregnancy

1 To whom correspondence should be addressed. E-mail: M004407{at}ms.skh.org.tw


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