Post IVF heterotopic pregnancy with one in cervix and one in uterus. Successful delivery after termination of the cervical pregnancy with intraamniotic feticide

Introduction

Cervical pregnancy is a rare kind of ectopic pregnancy. Heterotopic pregnancy is a condition, where we have one sac in the uterus and one in another location, usually because of IVF treatment. This scenario can become a life-threatening condition, if remain untreated.

Presentation of case

A 44-year-old woman underwent IVF (egg donation) with double embryotransfer and resulted in twin pregnancy, however heterotopic. One in cervix and one intrauterine. Until 8 weeks both pregnancies evoluting equally and then a decision made to terminate the cervical one. Her physician chose a transabdominal approach (amniocentesis wise); however, this attempt failed. Then, intracervical puncture by a reproductive specialist was attempted with potassium chloride injection and aspiration of the amniotic fluid. The pregnancy was terminated successfully, and no complications presented afterwards. The intrauterine pregnancy evoluted normally and a livebirth was achieved at 39 weeks.

Discussion

The current case represents an interesting way of terminating a cervical pregnancy even in the presence of a twin intrauterine sibling.

Conclusion

Patients with heterotopic pregnancies, should be encouraged not to terminate both pregnancies and to be referred in specialized reproductive and fetal maternity centers.