Persistent β-HCG increase after salpingectomy in tubal pregnancy: good or bad news?

Aims Heterotopic pregnancy is the occurrence of simultaneous intrauterine and extrauterine pregnancies. Although more frequently with assisted reproductive techniques, it is very rare in natural conception with a frequency of 1:30000 pregnancies. Hereafter, we want to present one case from our university hospital LMU Munich.

Materials A 36-year-old female 2G0P (status after tubal abortion 2 months ago) presented to our emergency ward with lower abdomen pain for 4 hours in the 4+6 gestation week.

Methods Due to results of the transvaginal ultrasound, a tubal pregnancy was diagnosed. A further intrauterine structure was primarily classified as a possible pseudogestational sac. Laparoscopic salpingectomy was consequently done.

Results As postoperative β-HCG has been rising and an intrauterine heartbeat has been detectable 4 days after surgery the structure primarily classified as a pseudogestational sac had been an intrauterine pregnancy in fact .

Conclusion Without a correct diagnostic, heterotopic pregnancy can be a life-threatening pathology. As it is very rare, clinicians should take special care, because the presence of an extrauterine pregnancy does not exclude an intrauterine pregnancy and vice versa.

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Publication History

Article published online:
07 October 2020