The term heterotopic pregnancy refers to the presence of two concurrent pregnancies. The first event takes the form of an intrauterine pregnancy and the other is an ectopic pregnancy, which happens outside the uterus, usually outside the fallopian tubes.
The dangers of a heterotopic pregnancy can be just as serious as those of an ectopic pregnancy, with the added problem that most parents wish to keep the viable pregnancy and have the unviable one terminated.
Rates of Heterotopic Pregnancy
Assisted reproductive procedures such as in vitro fertilization are most likely to result in heterotopic pregnancies, with 1 in 100 assisted pregnancies becoming such.
Contrary to popular misconception, the rate of this kind of pregnancy is relatively high in women who have a spontaneous conception (a natural conception), running from 1 % to 1 % of all pregnancies.
Symptoms
Symptoms of a heterotopic pregnancy may not exist for women who are experiencing one. This is especially concerning given that 50% of these pregnancies are only detected when the rupture of the fallopian tubes.
The following symptoms may be present:
- Abnormal vaginal bleeding
- Bloating
- Dizziness
- Fainting
- Mild-to-severe abdominal pain or cramping
- Nausea
- Pain in the side
- Vomiting
Go to your local hospital if you feel faint or feel severe pain or bleeding, or if you are experiencing any other worrisome symptoms because you can die if you do not take action.
Diagnosis
The difficulty in diagnosing heterotopic pregnancy when it is in its earliest stages is that women may experience vaginal bleeding and cramping, but these symptoms do occur during normal pregnancy.
In contrast, when a routine ultrasound is performed, many women overlook a heterotopic pregnancy since the technician may only consider the developing fetus in the uterus and not follow the procedure beyond that. Heterotopic pregnancy is usually only confirmed by ultrasound after week four or five.
If the person experiencing these symptoms has undergone an assisted reproductive procedure, he must be observed closely with blood tests. This should also apply to people who have undergone this procedure.
Treatment of Heterotopic Pregnancy
These pregnancies must be terminated because any fetus located outside the uterus cannot survive and could cause potentially life-threatening bleeding to the mother if the fetal tissue ruptures spontaneously.
This process typically involves surgery to remove the affected fallopian tube, which may or may not be required, but usually involves removing healthy intrauterine pregnancies before the surgery.
Contrary to the risk of miscarriage that is higher with these pregnancies (particularly when a rupture occurs), nearly half of all women who undergo a heterotopic pregnancy attain full-term pregnancy.
Depending on the circumstances, it is completely normal for you to grieve for the baby you lost during a heterotopic pregnancy even if the other was perfectly fine. Share your loss with others you trust.