TITLE:
Ectopic Molar Pregnancy with Coexistent Normal Intrauterine Pregnancy: A Report of an Unusual Diagnosis managed in Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon
AUTHORS:
Tompeen Isidore, Ekono Michel Roger Guy, Mendouga Menye Coralie, Belinga Etienne, Noa Ndoua Cyrille, Foumane Pascal
KEYWORDS:
Ectopic Molar Pregnancy, Heterotopic Pregnancy, Laparoscopy Surgery, YGOPH
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.5,
May
31,
2023
ABSTRACT: Background: Heterotopic pregnancy is a very rare event in a natural cycle. Its
incidence is rising mostly due to induction of ovulation or Assisted
Reproductive Technique. Most ectopic in heterotopic pregnancies are localized
in the fallopian tubes. The occurrence of molar tubal ectopic pregnancy
coexisting with intrauterine pregnancy is uncommon and consequently not often
considered a diagnostic possibility. Case Report: We report the case of
a 25-year-old woman, gravida 4 para 1, who complained of vaginal spotting and
lower abdominal pain after 6 weeks of amenorrhea following clomiphene citrate
ovarian stimulation. Transvaginal Ultrasonography revealed an intrauterine
pregnancy and an unruptured left tubal ectopic pregnancy. She underwent
successful laparoscopic salpingectomy while the intra-uterine pregnancy was
allowed to continue. The ectopic pregnancy tissue histology reported an ectopic
partial molar pregnancy. She subsequently had a normal vaginal delivery at 39
weeks and 3 days and her follow-up was uneventful. Conclusion: Heterotopic pregnancy is a rare but life-threatening condition. It should be
suspected in a pregnant woman with a risk factor of multiple gestations who
presents vaginal bleeding and lower abdominal pain in the context of early
pregnancy. Laparoscopic surgery is effective for confirming the diagnosis and
treating the ectopic component. Routine histological examination of tubal
specimens must be taken very seriously because some findings like molar
pregnancies may require specific management.