{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:24:37Z","timestamp":1730870677936,"version":"3.28.0"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T00:00:00Z","timestamp":1708214400000},"content-version":"vor","delay-in-days":48,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AJP Rep"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>Heterotopic triplet pregnancy, cesarean scar ectopic pregnancy, and pregnancy following uterine ablation are all rare events that confer significant morbidity including spontaneous abortion, intrauterine fetal demise, preterm labor, abnormal placentation, and uterine rupture. A woman in her 30s, G6P4014, with a history of uterine ablation presented with delayed menses and vaginal spotting with imaging showing two intrauterine pregnancies (one with cardiac activity) and one live pregnancy at the cesarean scar. The patient was extensively counseled on risk to her and to the pregnancies; treatment options were discussed including expectant management and termination of pregnancy. The patient underwent an uncomplicated dilation and curettage with bilateral salpingectomy and was discharged home the day of the procedure in stable condition. This case highlights the potential compound effect of comorbid conditions that can pose difficulty in counseling and management.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0044-1779654","type":"journal-article","created":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T23:31:46Z","timestamp":1708299106000},"page":"e91-e95","source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous Heterotopic Cesarean Scar Triplet Gestation Following Uterine Ablation"],"prefix":"10.1055","volume":"14","author":[{"given":"Zane Frazer","family":"Aldrich","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology and Maternal Fetal Medicine, Winnie Palmer Hospital for Women and Babies, Orlando, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rena","family":"Ow","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology and Maternal Fetal Medicine, Winnie Palmer Hospital for Women and Babies, Orlando, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khyaati","family":"Modii","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology and Maternal Fetal Medicine, Winnie Palmer Hospital for Women and Babies, Orlando, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"O'Leary","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology and Maternal Fetal Medicine, Winnie Palmer Hospital for Women and Babies, Orlando, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,2,18]]},"reference":[{"key":"ref1","first-page":"356131","article-title":"Heterotopic triplet pregnancy after in vitro fertilization with favorable outcome of the intrauterine twin pregnancy subsequent to surgical treatment of the tubal pregnancy","author":"T Felekis","year":"2014","journal-title":"Case Rep Obstet Gynecol"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1055\/s-0039-1683910","article-title":"Spontaneous heterotopic triplet pregnancy with two viable intrauterine embryos and an ectopic with right tubal rupture","volume":"41","author":"A C Guimar\u00e3es","year":"2019","journal-title":"Rev Bras Ginecol Obstet"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1093\/humrep\/13.7.1999","article-title":"An unexpected triplet heterotopic pregnancy after replacement of two embryos","volume":"13","author":"I Inion","year":"1998","journal-title":"Hum Reprod"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"291.e1","DOI":"10.1016\/j.fertnstert.2010.05.025","article-title":"Successful management of a triplet heterotopic caesarean scar pregnancy after in vitro fertilization-embryo transfer","volume":"95","author":"K Litwicka","year":"2011","journal-title":"Fertil Steril"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1002\/ajum.12242","article-title":"Ultrasound-guided procedures in the management of heterotopic caesarean scar pregnancy: a review of case reports and case series","volume":"24","author":"A J Authreya","year":"2021","journal-title":"Australas J Ultrasound Med"},{"key":"ref6","first-page":"5240848","article-title":"Second trimester heterotopic triplet pregnancy with intrauterine twin pregnancy and ruptured interstitial pregnancy: a maternal near-miss case report","author":"C Nkurunziza","year":"2020","journal-title":"Case Rep Obstet Gynecol"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"B2","DOI":"10.1016\/j.ajog.2020.01.030","article-title":"Society for Maternal Fetal Medicine (SMFM) consult series #49: cesarean scar pregnancies","volume":"222","author":"R Miller","year":"2020","journal-title":"Am J Obstet Gynecol"},{"key":"ref8","first-page":"1233","article-title":"ACOG practice bulletin # 81. 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