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63 - Ectopic and Heterotopic Pregnancies Following in Vitro Fertilization

from PART III - ASSISTED REPRODUCTION

Published online by Cambridge University Press:  04 August 2010

By
Ziad R. Hubayter  and
Suheil J. Muasher
Edited by
Botros R. M. B. Rizk ,
Juan A. Garcia-Velasco ,
Hassan N. Sallam  and
Antonis Makrigiannakis
Botros R. M. B. Rizk
Affiliation:
University of South Alabama
Juan A. Garcia-Velasco
Affiliation:
Rey Juan Carlos University School of Medicine,
Hassan N. Sallam
Affiliation:
University of Alexandria School of Medicine
Antonis Makrigiannakis
Affiliation:
University of Crete
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Summary

INTRODUCTION

Ectopic pregnancy is defined as an abnormal implantation of the conceptus in a location outside the uterine cavity. Heterotopic pregnancy is when there are concomitant intrauterine and extrauterine pregnancies (1). Ectopic pregnancy is a life-threatening condition and is one of the leading causes of maternal mortality. It accounts for 9 percent of all pregnancy-related deaths and is the most common etiology of maternal deaths in the first trimester (2).

Assisted reproductive technologies (ART) are associated with several medical complications. These include ovarian hyperstimulation syndrome, bleeding, infections (ovarian abcess and endometritis), and a higher incidence of ectopic pregnancies. The incidence of ectopic pregnancies is increased in ART due to a higher number of embryos transferred and a higher prevalence of tubal disease in patients undergoing in vitro fertilization (IVF) (3).

Abulcasis was the first to describe an ectopic pregnancy in the tenth century AD. He was an Arabic writer and one of the first to perform and discuss different types of surgical procedures. He discussed a case where he was able to retrieve fetal parts from a draining abdominal wound (4). Riolan, in the early seventeenth century, described a woman who died at four months of gestation. She presented with acute abdominal pain and syncope. Later, a fetus was identified in one of her fallopian tubes (5). In 1708, Duverney described a heterotopic pregnancy on autopsy (4).

Keywords

ectopic pregnanciesheterotopic pregnancieshuman chorionic gonadotropinlaparoscopymifepristonemethotrexatesalpingectomylaparotomyultrasound technology
Type
Chapter
Information
Infertility and Assisted Reproduction , pp. 619 - 628
Publisher: Cambridge University Press
Print publication year: 2008

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