Premium
Undiagnosed heterotopic pregnancy, maternal hemorrhagic shock, and ischemic stroke in the intrauterine fetus
Author(s) -
Ezzati Mohammad,
Shamshirsaz Alireza A.,
Haeri Sina
Publication year - 2015
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.4633
Subject(s) - heterotopic pregnancy , medicine , gestation , pregnancy , fetus , obstetrics , in vitro fertilisation , gynecology , gestational sac , genetics , biology
Heterotopic pregnancy occurs rarely following natural conception; however, intrauterine embryo transfer following in vitro fertilization is a known risk factor for its occurrence. A 29‐year‐old woman presented with acute abdomen at 14w5d gestation following in vitro fertilization–embryo treatment. A ruptured heterotopic gestation in the left fallopian tube was identified at laparoscopy and treated by salpingectomy. Subsequently, at 21‐week gestation, routine sonogram demonstrated bilateral ventriculomegaly in the intrauterine fetus. Fetal magnetic resonance imaging was highly suggestive of ischemic brain injury, most likely attributable to the maternal hypovolemic shock because of ruptured heterotopic gestation. The pregnancy was terminated by intracardiac injection and induction of labor. Timely diagnosis of heterotopic pregnancy requires a high index of suspicion as diagnostic delays can have catastrophic consequences for the mother and/or the intrauterine fetus. © 2015 John Wiley & Sons, Ltd.