Heterotopic pregnancy with suspicion of superfetation after the intrauterine insemination cycle with ovulation induction using clomiphene citrate: A case report

  • Ayumu Ito | ayumu.itou@med.toho-u.ac.jp Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken; Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, Ota-ku, Tokyo-to, Japan.
  • Takamasa Furukawa Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken, Japan.
  • Kentaro Nakaoka Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken; Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, Ota-ku, Tokyo-to, Japan.
  • Rika Hayashi Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken; Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, Ota-ku, Tokyo-to, Japan.
  • Tadashi Namihira Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken; Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, Ota-ku, Tokyo-to, Japan.
  • Sadanori Kasai Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken; Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, Ota-ku, Tokyo-to, Japan.
  • Kazuko Shimai Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken, Japan.
  • Kenji Takahashi Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken; Department of Obstetrics and Gynecology, Faculty of Medicine, Toho University, Ota-ku, Tokyo-to, Japan.
  • Masahito Nakakuma Department of Obstetrics and Gynecology, Ageo Central General Hospital, Ageo-shi, Saitama-ken, Japan.

Abstract

At 22 days after intrauterine insemination with ovulation induction using clomiphene citrate at a previous hospital, a 30-year-old woman was admitted to our hospital owing to right lower quadrant abdominal pain. We diagnosed threatened abortion because of a gestational sac in the uterus on transvaginal ultrasonography. The next day, she complained of increased abdominal pain. Transvaginal ultrasonography revealed a gestational sac-like structure in the echo free space. She was diagnosed with heterotopic pregnancy due to a ruptured right tubal pregnancy, underwent laparoscopic right salpingectomy. Rupture of a gestational age of 5 weeks is extremely rare. If this was a case of a heterotopic pregnancy due to superfetation, it could be explained as this clinical course. When a pregnant woman develops abdominal pain, heterotopic pregnancies should not be excluded from the differential diagnosis, and the possibility of superfetation should be taken into consideration.

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Published
2019-03-25
Info
Issue
Section
Case Reports
Keywords:
Ectopic pregnancy, Heterotopic pregnancy, Infertility treatment, Laparoscopic surgery, Superfetation
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How to Cite
Ito, A., Furukawa, T., Nakaoka, K., Hayashi, R., Namihira, T., Kasai, S., Shimai, K., Takahashi, K., & Nakakuma, M. (2019). Heterotopic pregnancy with suspicion of superfetation after the intrauterine insemination cycle with ovulation induction using clomiphene citrate: A case report. Clinics and Practice, 9(1). https://doi.org/10.4081/cp.2019.1129