Open AccessHeterotopic Pregnancy with Suspicion of Superfetation after the Intrauterine Insemination Cycle with Ovulation Induction Using Clomiphene Citrate: A Case Report
Author(s) -
Ayumu Ito,
Takamasa Furukawa,
Kentaro Nakaoka,
Ryohei Hayashi,
Tadashi Namihira,
Sadanori Kasai,
Kazuko Shimai,
Kenji Takahashi,
Masahito Nakakuma
Publication year - 2019
Publication title -
clinics and practice
Language(s) - English
Resource type - Journals
ISSN - 2039-7283
DOI - 10.4081/cp.2019.1129
Subject(s) - medicine , heterotopic pregnancy , gestational sac , pregnancy , abdominal pain , gynecology , obstetrics , ovulation induction , ectopic pregnancy , ovulation , surgery , genetics , hormone , biology
At 22 days after intrauterine insemination with ovulation induction using clomiphene citrate at a previous hospital, a 30-year-old woman was admitted to our hospital owing to right lower quadrant abdominal pain. We diagnosed threatened abortion because of a gestational sac in the uterus on transvaginal ultrasonography. The next day, she complained of increased abdominal pain. Transvaginal ultrasonography revealed a gestational sac-like structure in the echo free space. She was diagnosed with heterotopic pregnancy due to a ruptured right tubal pregnancy, underwent laparoscopic right salpingectomy. Rupture of a gestational age of 5 weeks is extremely rare. If this was a case of a heterotopic pregnancy due to superfetation, it could be explained as this clinical course. When a pregnant woman develops abdominal pain, heterotopic pregnancies should not be excluded from the differential diagnosis, and the possibility of superfetation should be taken into consideration.