II. Definitions
- Heterotopic Pregnancy (Compound Ectopic Pregnancy)
- Simultaneous ectopic AND intrauterine pregnancy
III. Epidemiology
- Associated with Assisted Reproductive Technologies (Infertility Treatment) in up to 1-3% of pregnancies
- Rare in spontaneous (non-ART) pregnancy: 1 in 30,000 pregnancies
IV. Labs
- See Ectopic Pregnancy
-
Quantitative bhCG
- May be misleading due to normal increases with the intrauterine pregnancy
V. Imaging: Ultrasound
- Identification of intrauterine pregnancy does not exclude Ectopic Pregnancy
- Ultrasound the Pelvis and Adnexa in addition to intrauterine cavity
VI. Management
- See Ectopic Pregnancy
- Consult obstetrics
- Emergent surgery indications
- FAST Exam positive for intraabdominal free fluid
- Hemodynamic instability
- Significant exam findings (e.g. significant Abdominal Pain)
VII. References
- Gallo, Suyama and Snook (2020) Crit Dec Emerg Med 34(10): 3-7