Heterotypic Ectopic PregnancyTubal pregnancy may be accompanied by a coexisting uterine gestation. Until recently, such heterotypic pregnancies were rare, with an incidence of 1 per 30,000 pregnancies. Currently, because of assisted reproduction, the incidence is likely 1 in 7000 overall, and following ovulation induction it may be as high as 1 in 900.
A heterotypic pregnancy is more likely, and should be considered:
- After assisted reproductive techniques.
- With persistent or rising chorionic gonadotropin levels after dilatation and curettage for an induced or spontaneous abortion.
- When the uterine fundus is larger than menstrual dates.
- With more than one corpus luteum.
- With absence of vaginal bleeding in the presence of signs and symptoms of an ectopic pregnancy.