Heterotopic simultaneous splenic and intrauterine pregnancy after spontaneous conception and review of literature
Article first published online: 13 JUN 2012
© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology
Journal of Obstetrics and Gynaecology Research
Volume 39, Issue 1, pages 367–370, January 2013
How to Cite
Julania, S. and Tai, R. (2013), Heterotopic simultaneous splenic and intrauterine pregnancy after spontaneous conception and review of literature. Journal of Obstetrics and Gynaecology Research, 39: 367–370. doi: 10.1111/j.1447-0756.2012.01920.x
- Issue published online: 7 JAN 2013
- Article first published online: 13 JUN 2012
- Received: May 24 2011.; Accepted: March 21 2012.
- abdominal pregnancy;
- chorionic gonadotropin beta subunit human;
- ectopic pregnancy;
A 31-year-old woman presented to the emergency department with sudden onset left upper quadrant pain radiating to the left shoulder. Urine β-hCG test was positive. Transvaginal sonography was suggestive of ruptured ectopic pregnancy with a large amount of free fluid in the pouch of Douglas. The patient was then taken for emergency laparoscopy. On laparoscopy, hemoperitoneum was noted but both the fallopian tubes and ovaries were normal. On further exploration, bleeding was noted from the spleen so laparotomy was performed and emergency splenectomy was carried out by a surgeon. The histopathology report of the spleen confirmed a splenic ectopic pregnancy. On postoperative follow-up, the patient's quantitative serum β-hCG started rising again, which raised suspicion of another pregnancy. After serial β-hCG and ultrasound, a failed intrauterine pregnancy was diagnosed. Suction evacuation was performed, with histopathology confirming products of conception.