IMR Press / CEOG / Volume 49 / Issue 1 / DOI: 10.31083/j.ceog4901012
Open Access Case Report
A case of heterotopic pregnancy with intrauterine and cervical pregnancy coexisting: intrasacular KCl injection, intrauterine pregnancy being preserved, and then massive bleeding at 32 weeks
Show Less
1 Department of Obstetrics & Gynecology of Miguel Servet University Hospital, 50009 Zaragoza, Spain
2 Department of Obstetrics & Gynecology of Lozano Blesa University Clinical Hospital, 50009 Zaragoza, Spain
*Correspondence: jnavarro_11@telefonica.net (Javier Navarro Sierra)
Academic Editor: Michael H. Dahan
Clin. Exp. Obstet. Gynecol. 2022, 49(1), 12; https://doi.org/10.31083/j.ceog4901012
Submitted: 7 February 2021 | Revised: 5 May 2021 | Accepted: 8 May 2021 | Published: 12 January 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Heterotopic pregnancy is the condition in which intrauterine and ectopic pregnancy coexist. The conservative management of the ectopic pregnancy, with the intrauterine pregnancy preserved, has been reported. Case(s): Here, we report a very rare case: intrauterine and cervical pregnancy coexist: intrasacular Potassium chloride (KCL) injection successfully terminated cervical pregnancy with intrauterine pregnancy preserved, but later massive bleeding occurred from the cervix. A 39-year-old woman at 7+1 weeks was diagnosed with a heterotopic cervical gestation, with intrauterine and cervical sac, both with live embryos. The ectopic pregnancy was successfully terminated with intrasacular injection of KCl, preserving the intrauterine pregnancy. At 32+4 weeks of gestation the patient started with a profuse bleeding from the cervical sac, causing maternal hypotension (80/45 mmHg) and tachycardia (160 bpm) and a decelerative pattern in the cardiotocographic fetal monitoring, prompting us to perform caesarean section. The cessation of bleeding was achieved using a double balloon intracervical catheter, which was withdrawn 24 hours after its insertion without observing a new bleeding episode. The patient was discharged after 8 days and the newborn after 35 days of life, both in good health. Conclusions: Conservative treatment of a heterotopic gestation is possible, managing to preserve the viability of the intrauterine pregnancy.

Keywords
Cervical heterotopic pregnancy
Conservative management
Heterotopic pregnancy
Pregnancy outcome
Severe bleeding
Figures
Fig. 1.
Share
Back to top