Heterotopic Pregnancy

Usually the presence of an intrauterine pregnancy is sufficient evidence that an EP does not exist. However, in the case of patients who are taking progestational/fertility agents, this assumption should not be made. The incidence of simultaneous intrauterine and extrauterine pregnancy (heterotopic pregnancy) in the general population is now thought to be as high as 1 per 4000 pregnancies, although historically this was only reported in 1 per 30,000 pregnancies. Those taking medications to enhance fertility are at much higher risk for heterotopic pregnancy. Patients who have a history of in vitro fertilization may have an incidence as high as 1 per 100 to 200 pregnancies.15 For this reason sonographic imaging of the entire pelvis should be completed even after identification of an obvious IUP.

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