Journal of Womens Health, Issues and CareISSN: 2325-9795

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Research Article, J Womens Health Issues Care Vol: 5 Issue: 5

Diagnosis, Management and Outcomes of Heterotopic Pregnancies: About 28 Cases with Literature Review

Khlifi Abdeljalil1*, Hachani Feten1, Ferhi Fehmi2, Chachia Salma1, Essaidi Habib1, Kebaili Sahbi3, Boughizane Sassi1, Chaabane Kais3, Ben Regaya Lassaad1 and Khairi Hedi1
1Faculty of medicine Ibn Eljazzar of Sousse, Department of obstetrics& Gynecology, Sousse University, Tunisia
2Department of anesthesia, University Hospital of Farhat Hached, Sousse University, 4000 Sousse, Tunisia
3University Hospital of Hedi Chaker, South University, Sfax, Tunisia
Corresponding author : Dr. Khlifi Abdeljalil
Department of obstetrics & Gynecology, Sousse University, Tunisia
Tel: 00216 97 405 734
Fax: 00216 73102 501
Received: June 27, 2016 Accepted: July 28, 2016 Published: August 02, 2016
Citation: Abdeljalil K, Feten H, Fehmi F, Salma C, Habib E, et al. (2016) Diagnosis, Management and Outcomes of Heterotopic Pregnancies: About 28 Cases with Literature Review. J Womens Health, Issues Care 5:5. doi:10.4172/2325-9795.1000243


Objective: To identify the diagnostic difficulties and to assess heterotopic pregnancy outcomes.
Patients and methods: A retrospective bi-centric study over 28 cases of heterotopic pregnancies was conducted at both Obstetrics and Gynecology Departments of the University Hospitals of Farhat Hached, Sousse (Tunisia) and Hedi Chaker, Sfax (Tunisia) between 2001 and 2014. Data on patients’ symptoms, risk factors, diagnostic features, treatment and outcome were collected and analysed.
Results: The average age was 32.2 years. The frequency of heterotopic pregnancies was 1/8567. A history of pelvic surgery, pelvic infection and infertility was identified in respectively 46.4%, 32.1% and 32.1% of cases. More than the third of patients (39.3%) conceived after ovarian stimulation. The diagnosis was delayed in 75% of cases. thirteen patients (46.4% of cases) presented a hypovolemic shock and were managed surgically by laparotomy. The rupture of ectopic pregnancy was found in 53.6% of cases. Salpingectomy was performed in 84.6% of cases and 60.7% of the intra uterine pregnancies have been pursued, giving birth to 17 healthy newborns.
Conclusion: The systematic screening by transvaginal ultrasonography at the first consultation could allow early diagnosis and improve prognosis.

Keywords: Ectopic pregnancy; Heterotopic pregnancy; Laparoscopy; Literature review; In-vitro fertilization

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