Zusammenfassung
Seitdem die Anzahl der durch assistierte Reproduktion entstandenen Schwangerschaften zunimmt, steigt die in der Vergangenheit seltene Diagnosestellung der heterotopen Schwangerschaft stetig an. Um den intrauterinen Fetus zu retten und die maternale Morbidität und Mortalität zu reduzieren, ist es essenziell einer verspäteten Diagnosestellung vorzubeugen. In diesem Fallbericht wird dargestellt, dass die diagnostischen Schwierigkeiten eine frühe Diagnosestellung der Simultangravidität trotz verbesserter Techniken erschweren. Die Möglichkeit der Prävention durch Transfer nur eines Embryos bei assistierter Reproduktion sollte somit weiterhin diskutiert werden. Es wird herausgearbeitet, dass bei durch assistierte Reproduktion entstandenen Schwangerschaften eine engmaschige Überwachung mit hochauflösendem Ultraschall essenziell ist, da die frühe Diagnose der heterotopen Gravidität in einem vergleichbaren perinatalen Outcome resultiert wie bei Einlingsschwangerschaften.
Abstract
Although spontaneous simultaneous intrauterine and ectopic pregnancy was an extremely rare event in the past, it is increasingly being diagnosed since the rate of assisted reproduction technique (ART) gestations increased. Due to the serious consequences, delayed diagnosis should be prevented in order to salvage the viable intrauterine fetus and avoid maternal morbidity and mortality. This case report demonstrates that the pitfalls of the diagnosis of heterotopic pregnancy make early diagnosis difficult and the prevention of heterotopic pregnancies by single embryo transfer should be continuously discussed. The role of high resolution ultrasound scans and the importance of close monitoring of early pregnancies following ART are emphasized because early diagnosis of heterotopic pregnancy results in a similar perinatal outcome as singleton pregnancies.
Key words
heterotopic pregnancy - ectopic pregnancy - simultaneous pregnancy
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Karin Lautmann
Frauenklinik, Medizinische Hochschule Hannover
Carl-Neuberg-Str. 1
30625 Hannover
Phone: ++49/5 11/53 20
Fax: ++49/5 11/5 32 61 45
Email: Lautmann.Karin@mh-hannover.de