heterotopic gestation

description

heterotopic pregnancy is the occurrence of a multiple pregnancy in which one or more gestational sacs are implanted outside the uterine cavity (ectopic pregnancy) associated with a single or multiple intrauterine pregnancy (eutopic pregnancy). originally a rare condition, it is now more commonly seen with the increased use of assisted reproduction (ovulation induction, multiple embryo transfer).

diagnosis

the presence of a small pelvic mass associated with an early intrauterine pregnancy is suggestive of heterotopic pregnancy. the diagnosis may be made by the identification of a fetal pole with or without a heartbeat in the ectopic gestation. patients with diagnosis of ectopic pregnancy, in particular those who have undergone infertility treatment, must have the uterine cavity investigated to exclude heterotopic pregnancy.

differential diagnosis

no other condition should be confused with heterotopic gestation as long as careful scanning is done. however, a pedunculated fibroid, ovarian cyst or neoplasm in the presence of an intrauterine pregnancy, might be mistaken for this condition.

sonographic features

adnexal mass in association with intrauterine pregnancy