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Heterotypic Ectopic Pregnancy

Tubal 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:

  1. After assisted reproductive techniques.
  2. With persistent or rising chorionic gonadotropin levels after dilatation and curettage for an induced or spontaneous abortion.
  3. When the uterine fundus is larger than menstrual dates.
  4. With more than one corpus luteum.
  5. With absence of vaginal bleeding in the presence of signs and symptoms of an ectopic pregnancy.

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