Abstract

BARRON VALLEJO, Jesús et al. Heterotopic pregnancy with the new techniques of assisted reproduction. Case report. Rev. Fac. Med. (Méx.) [online]. 2018, vol.61, n.2, pp.16-19. ISSN 2448-4865.

We present the case of a 39-year-old infertile woman with the diagnosis of diminished ovarian reserve and a history of four previous attempts of in vitro fertilization, which were unsuccessful. She was treated by means of in vitro fertilization with oocyte donation, two embryos being transferred. Two weeks after embryo transfer, the pregnancy test was positive. Two weeks later a vaginal ultrasound was performed, finding an intrauterine gestational sac, within which an embryo with cardiac beat was detected. The pregnancy had a normal evolution until three weeks after the pregnancy test when the patient presented with left-sided lower abdominal pain. On examination, guarding and rebound signs in the left iliac fossa were positive. A vaginal ultrasound was performed, encountering both an intrauterine fetus with cardiac beat and a left tubal ectopic pregnancy. The patient was treated by means of Pfannenstiel incision laparotomy with a left salpingectomy. After surgery, the patient was treated with uterine contractility inhibitors. The pregnancy progressed without complications until the thirty-fifth week, when the patient presented premature rupture of membranes. A cesarean section was performed obtaining a live male, weighing 2500g. The newborn developed mild respiratory distress and pulmonary artery hypertension, for which a surfactant agent and sildenafil were administered. He was deemed healthy and egressed.

Keywords : Infertility; heterotopic pregnancy; assisted reproduction.

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