Ospan A Mynbaev, Artur K Khachatryan, Ioannis P Kosmas, Marina Yu Eliseeva, A Khachatryan, Antonio Malvasi and Andrea Tinelli
Case of heterotopic quadruplet pregnancy with coexistence of tubal and intrauterine twins. Objective (s): To present the case heterotopic quadruplet pregnancy with coexistence of tubal and intrauterine twins and its successful surgical management with brief literature review. Design: A case report supplemented with brief literature review and discussion. Setting: City clinical university hospital. Patient (s): Heterotopic quadruplet pregnancy with tubal and intrauterine twins in a 31-year-old woman after natural conception. Intervention (s): Laparoscopy, adhesiolisys, aspiration of tubal embryos through tubotomy and cervical dilatation and vacuum aspiration of intrauterine embryos as well as vaginal and intraoperative laparoscopic ultrasound examination. Main outcome measure (s): Physical examination, laparoscopy and postsurgical hCG serum assay, as well as preintra- and postoperative vaginal ultrasound and intraoperative laparoscopic sonography. Result (s): Successful diagnosis and treatment of a case of heterotopic quadruplet pregnancy with coexistence of tubal and intrauterine twins in a 31-year-old woman with 6 artificial abortions, pelvic inflammatory diseases and periadnexal adhesions, after natural conception was described. An intraoperative laparoscopic sonography was applied to complete diagnosis of heterotopic pregnancy with coexistence of tubal and intrauterine twins after control of bleeding and stabilization of patient condition due to necessity to perform an emergency surgery. The case was supplemented with a brief review of literature and discussion. Conclusion (s): A unique case of heterotopic quadruplet pregnancy with coexistence of tubal and intrauterine twins after natural conception was presented in the first time.
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