Case Series Volume 14 Issue 10 - 2025

Management of Heterotopic Pregnancy: A Case Series

Sebnem Selek1*, Eric Auyoung2, Taner Kasapoglu3, Nabila Iram2 and Ziena Abdullah2,4

1Royal Marsden NHS Foundation Trust, London, UK

2The Princess Alexandra Hospital NHS Trust, Harlow, UK

3Guy’s and St Thomas' NHS Foundation Trust, London, UK

4Tawam Hospital, Abu Dhabi, United Arab Emirates

*Corresponding Author: Sebnem Selek, Royal Marsden NHS Foundation Trust, London, UK.
Received: September 26, 2025; Published: October 08, 2025



Heterotopic pregnancy, defined as the coexistence of intrauterine and ectopic gestations, is a rare but potentially life-threatening condition. This case series presents multiple instances encountered in early pregnancy, each with distinct clinical presentations and diagnostic pathways. The report highlights the importance of high clinical suspicion, timely imaging, and individualized management strategies. Through these cases, we underscore the challenges of conservative versus surgical intervention and the need for multidisciplinary coordination to optimize maternal and foetal outcomes.

 Keywords: Heterotopic Pregnancy (HP); Assisted Reproductive Technologies (ART)

  1. Oancea M., et al. “Spontaneous heterotopic pregnancy with unaffected intrauterine pregnancy: systematic review of clinical outcomes”. Medicina (Kaunas, Lithuania) 12 (2020): 665.
  2. Talbot K., et al. “Heterotopic pregnancy”. Journal of Obstetrics and Gynaecology 1 (2011): 7-12.
  3. Perkins KM., et al. “Risk of ectopic pregnancy associated with assisted reproductive technology in the United States, 2001–2011”. Obstetrics and Gynecology 1 (2015): 70-78.
  4. Sun SY., et al. “Diagnosis of heterotopic pregnancy using ultrasound and magnetic resonance imaging in the first trimester of pregnancy: a case report”. Case Reports in Radiology (2012): 317592.
  5. Hassani KIM., et al. “Heterotopic pregnancy: A diagnosis we should suspect more often”. Journal of Emergencies, Trauma, and Shock 3 (2010): 304.
  6. Rizk B., et al. “Heterotopic pregnancies after in vitro fertilization and embryo transfer”. American Journal of Obstetrics and Gynecology 1.1 (1991): 161-164.
  7. Karampas G., et al. “Heterotopic pregnancy after bilateral salpingectomy, IVF and multiple embryos transfer. A case report and systematic review of the literature”. Journal of Obstetrics and Gynaecology 5 (2022): 809-815.
  8. Michał M., et al. “Heterotopic pregnancy in the absence of risk factors--diagnostics difficulties”. Ginekologia Polska 11 (2011): 866-868.
  9. Ouafidi B., et al. “Diagnosis and management of a spontaneous heterotopic pregnancy: Rare case report”. International Journal of Surgery Case Reports 84 (2021): 106184.
  10. Ge F., et al. “Management of heterotopic pregnancy: clinical analysis of sixty-five cases from a single institution”. Frontiers in Medicine 10 (2023): 1166446.
  11. Młodawski J., et al. “Conservative management of heterotopic pregnancy: a case report and review of literature”. American Journal of Case Reports 24 (2023): e940111.
  12. Kim MG., et al. “Conservative management of spontaneous heterotopic cervical pregnancy using an aspiration cannula and pediatric Foley catheter”. Ultrasound in Obstetrics and Gynecology 6 (2009): 733-734.
  13. Deka D., et al. “Successful management of heterotopic pregnancy after fetal reduction using potassium chloride and methotrexate”. Journal of Human Reproductive Sciences 1 (2012): 57-60.
  14. Agrawal M., et al. “Fetal reduction by potassium chloride infusion in unruptured heterotopic pregnancy: a comprehensive review”. Cureus2 (2024): e53618.
  15. Cucinella G., et al. “Early diagnosis and surgical management of heterotopic pregnancy allows us to save the intrauterine pregnancy”. Menopause Review/Przegląd Menopauzalny 4 (2021): 222-225.
  16. Bouab M., et al. “Spontaneous heterotopic pregnancy: Diagnosis and surgical management”. International Journal of Surgery Case Reports 118 (2024): 109582.
  17. Rezai S., et al. “Laparoendoscopic single-site surgery for management of heterotopic pregnancy: a case report and review of literature”. Case Reports in Obstetrics and Gynecology (2018): 7232637.

Sebnem Selek., et al. “Management of Heterotopic Pregnancy: A Case Series”. EC Gynaecology  14.10 (2025): 01-08.