Miracle Baby: very Rare Case of Heterotopic Pregnancy with Cervical Ectopic in Elderly Primigravida with very Poor Ovarian Reserve with Oligoastheno-Terato-Zoospermia Conceived with IVF


Affiliations

  • Dr. Balabhai Nanavati Hospital, Mumbai, India
  • Dr. R N Cooper Hospital, Mumbai, India

Abstract

A 42 year old with primary infertility over 2 years with poor ovarian reserve (AMH 0.02) with an Oligoastheno-terato-zoospermia had 3 attempts of embryo transfer with her own egg. USG showed a heterotopic pregnancy with fundal 5-6 weeks intrauterine gestational sac with a cervical ectopic with small subchorionic collection along with posterior uterine wall. Despite embryo reduction, it still showed a persistent heterotopic pregnancy with an increasing subchorionic collection in the cervical canal. There was PROM at 27 weeks and under adequate antibiotic and steroid cover, classical caesarean section was done. Due to an adherent cervical pregnancy remnant, bilateral internal iliac artery ligation with an obstetric hysterectomy was done. As few cases exist in literature, there are no specific and no universally accepted treatment modality for heterotopic cervical pregnancy and treatment depends on experience, equipment of medical team and maternal conditions.

Keywords

Ovarian Reserve, Heterotopic Pregnancy, Embryoreduction, Obstetric Hysterectomy.

Subject Discipline

Obstetrics and Gynaecology

Full Text:

References

Isikoglu M. Heterotopic cervical pregnancy: Conservative treatment with transvaginal embryo aspiration. IVF Lite 2015;2:37-41.

Asha Baxi, Manila Kaushal, HK Karmalkar, Peeti Sahu, Pooja Kadhi, Baxi Daval. Successful expectant management of tubal heterotopic pregnancy. J Hum Reprod Sci 2010 MayAug;3(2):108–110.

Honey L, Leader A, Claman P. Uterine artery embolization—a successful treatment to control bleeding cervical pregnancy with a simultaneous intrauterine gestation. Hum Reprod 1999;14:553–5.

Deepika Deka, Anupama Bahadur, Aprajita Singh, Neena Malhotra Successful management of heterotopic pregnancy after fetal reduction using potassium chloride and methotrexate . J Hum Reprod Sci 2012 Jan-Apr;5(1):57– 60.

Kung FT, Chang SY, Tsai YC, Hwang FR, Hsu TY, Soong YK. Subsequent reproduction and obstetric outcome after methotrexate treatment of cervical pregnancy: A review of original literature and international collaborative follow-up. Hum Reprod 1997;12:591–5.

Chen D, Kligman I, Rosenwaks Z. Heterotopic cervical pregnancy successfully treated with transvaginal ultrasound-guided aspiration and cervical-stay sutures. Fertil Steril 2001;75:1030–3.


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