Ömer DEMİRTAŞ, Gülşah DEMİRTAŞ, Emre GÜLTEKİN, Ali Öner ERDOĞDU, Bülent YEŞİLYURT

Primer infertilite hikayesi olan bir hastada spontan heterotopik gebelik: bir olgu sunumu

Heterotopik gebelik iki veya daha fazla gebelik kesesinin aynı anda biri kavitede diğeri ise sıklıkla tubada olması ile karakterize bir durumdur. Spontan heterotopik gebelik ise 30000 de bir gibi az bir oranla 28 yaşında acil servise akut batın tablosu ile başvuran spontan heterotopik gebelik tanılı bir hasta sunduk. Hasta ultrasonografi ile değerlendirildiğinde sol tubal ektopik gebelik komponenti ile birlikte intrauterin gebeliği mevcuttu. Laparoskopiye alınan hastaya başarılı sol salpenjektomi uygulandı. Postoperatif gebelik 7. haftaya kadar devam etti. Ancak embriyo bu haftada kaybedildi.Obstetrisyen özellikle risk faktörü bulunan hastalar için heterotopik gebeliği akılda tutmalı, risk faktörü olmayan hastalarda ise tanının atlanmaması için erken gebelik haftalarında intrauterin gebelik izlense de adneksial alan ve pelvis mutlaka bu açıdan transvaginal ultrasonografi ile değerlendirilmelidir.

Spontaneous heterotopic pregnancy in a patient with a history of primary infertility: a case report

Heterotopic pregnancy is characterized as the presence of two or more gestation sacs, in the uterine cavity and the other usually in the fallopian tube. Spontaneous heterotopic pregnancy is rarely diagnosed with a 1/30.000 incidence.We present a 28 year old patient admitted to the emergency room with acute abdomen, diagnosed with spontaneous heterotopic pregnancy. Assessed by ultrasound, the patient had a left tubal ectopic pregnancy component with an intrauterine pregnancy. The patient underwent a successful laparoscopic left salpingectomy. Postoperatively, pregnancy continued until the 7th week and then the embryo died.Obstetricians should keep heterotopic pregnancy in mind especially for patients with risk factors; and for those without risk factors, in the early gestational weeks of intrauterine pregnancies, the adnexal and pelvis must be assessed with transvaginal ultrasonography,in order not to miss the diagnoses.

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