On day 30 after ET, the patient had her first ultrasound, which revealed an embryo in the uterus. On the 14th day after embryo transfer (ET), she routinely received a serum β-human chorionic gonadotropin (β-hCG) test, which showed 2372 IU/L, indicating pregnancy. She had undergone in vitro fertilization (IVF) and transferred two frozen embryos into the uterine cavity at the hospital 38 days prior. Thus, attention must be paid to the following issues: the desire of the expectant parents for the health of the baby in utero and the protection of future fertility, and the threat to the life of the mother and intrauterine fetus by ectopic gestational sac rupture.Ī 31-year-old woman came to Peking University Shenzhen Hospital complaining of slight vaginal bleeding and tenesmus for 8 h. The existence of IUP also increases the complexity of HIP diagnosis and treatment. In recent years, with the increase in infertility and the development of assisted reproductive technology (ART), the incidence of HIP has greatly increased. During natural conception, the incidence of HIP is very low. The coexistence of an IP and an intrauterine pregnancy (IUP) is called a heterotopic interstitial pregnancy (HIP), which is the most life-threatening type of EP. The maternal mortality rate is as high as 2.5%, which is seven times that of other types of tubal EP. The gestational sac is implanted into the interstitial part of the fallopian tube, and the surrounding blood supply is rich. Interstitial pregnancy (IP) is a rare ectopic pregnancy (EP), accounting for 2–4% of tubal EP. Early treatment of concomitant heterotopic pregnancy is associated with high survival of the intrauterine pregnancy. Interventional ultrasound therapy and surgery are equally safe and effective. Conclusions: The diagnosis and treatment of HIP remain challenging. All fetuses were born without abnormalities. In total, 76.9% (20/26) of intrauterine pregnancies had a good prognosis (surgery vs. According to these studies, 84.6% (22/26) of these cases were conceived by in vitro fertilization embryo transfer, 57.7% (15/26) had tubal disorders, and 23.1% (6/26) had a history of ectopic pregnancy 53.8% (14/26) of the patients presented with abdominal pain and 19.2% (5/26) had vaginal bleeding. Combined with our case, there were 26 cases in total. Twenty-five HIP cases in 24 studies published on PubMed from 1992 to 2021 were reviewed. The intrauterine pregnancy was successfully delivered at 38 weeks of gestation. The interstitial gestational sac was inactivated by ultrasound-guided methotrexate injection. Results: The patient was diagnosed with HIP by transvaginal ultrasound (TVUS) at 8 weeks after assisted reproductive technology. Methods: The paper describes the medical history, clinical manifestations, treatment history, and clinical prognosis of a 31-year-old woman with HIP, and reviews cases of HIP from 1992 to 2021 published in the PubMed database. Purpose: This study aims to share the experience of minimally invasive ultrasound-guided methotrexate intervention in the treatment of heterotopic interstitial pregnancy (HIP) with good pregnancy outcomes, and to review the treatment, pregnancy outcomes, and impact on the future fertility of HIP patients.
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