Combined Pregnancy

Bello GV, GAETANO V. BELLO, G V Bello, D Schonholz, David H. Schonholz, Schonholz D, J Moshirpur, Moshirpur J, Dai-Yun Jeng, D Y Jeng, Jeng DY, Richard L. Berkowitz, Berkowitz RL, R L Berkowitz
Obstetrical & gynecological survey · 1986 · vol. 41(10) , pp. 603–613 · doi:10.1097/00006254-198610000-00001 · PMID:3774265 · W1972207542
article OA: closed CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by qwen3.7-flash, 2026-09-08 ⓘ

This report describes nine cases of heterotopic pregnancy, highlighting their diverse clinical presentations in patients with endometriosis or infertility and advocating for early laparoscopy to ensure accurate diagnosis and prevent inadvertent termination of intrauterine gestations.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-09-08 · read from full text ⓘ

This case series from The Mount Sinai Medical Center examines nine instances of heterotopic pregnancy, defined as the coexistence of intrauterine and extrauterine gestations. The authors highlight diverse clinical presentations, including cases arising after postabortal states, endometriosis treatment, and ovulation induction, while noting historical diagnostic challenges. Ultrasonography is discussed for its utility and limitations in detection, with recommendations for early laparoscopic intervention when clinical suspicion is high. A significant caveat involves the risk of inadvertently terminating a viable intrauterine pregnancy during curettage intended for ectopic management in infertility patients. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Nine recent cases of coexisting intra- and extrauterine pregnancy at The Mount Sinai Medical Center are presented. The myriad of clinical presentations is exemplified in the postabortal, endometriosis, posttreatment; ovulation induction, and routine "rule-out ectopic" situations. A brief review of the literature follows detailing historical reports of diagnostic inaccuracy and delayed diagnosis. Several studies are cited supporting the difficulty of correctly diagnosing heterotopic pregnancy as well as factors which may predispose to it. The advantages and pitfalls of ultrasonography are mentioned as well as recommendations for early laparoscopic intervention when clinical history and ultrasound are suggestive. Caution is advised in those infertility patients who may undergo "routine" curettage at laparoscopy for ectopic pregnancy and thus, be at risk for inadvertent termination of an otherwise salvageable intrauterine pregnancy. This report further supports several other reviews in noting that the incidence of combined pregnancy may be much greater than formerly appreciated.
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Combined Pregnancy The Mount Sinai Experience - GAETANO V. BELLO - DAVID SCHONHOLZ - JASMIN MOSHIRPUR - DAI-YUN JENG - RICHARD L. BERKOWITZ Nine recent cases of coexisting intra- and extrauterine pregnancy at The Mount Sinai Medical Center are presented. The myriad of clinical presentations is exemplified in the postabortal, endometriosis, posttreatment; ovulation induction, and routine “rule-out ectopic” situations. A brief review of the literature follows detailing historical reports of diagnostic inaccuracy and delayed diagnosis. Several studies are cited supporting the difficulty of correctly diagnosing heterotopic pregnancy as well as factors which may predispose to it. The advantages and pitfalls of ultrasonography are mentioned as well as recommendations for early laparoscopic intervention when clinical history and ultrasound are suggestive. Caution is advised in those infertility patients who may undergo “routine” curettage at laparoscopy for ectopic pregnancy and thus, be at risk for inadvertent termination of an otherwise salvageable intrauterine pregnancy. This report further supports several other reviews in noting that the incidence of combined pregnancy may be much greater than formerly appreciated.

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Condition tags

endometriosisinfertility

MeSH descriptors

Pregnancy Pregnancy, Ectopic Adult Female Humans Pregnancy, Ectopic Pregnancy, Ectopic Pregnancy, Ectopic Pregnancy, Tubal Pregnancy, Tubal Pregnancy, Tubal

Citation neighborhood (sparse)

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Cited by (2)

Cited by (2)

Source provenance

europepmc
last seen: 2026-10-04T09:26:46.659050+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
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License: CC0 · commercial use OK