{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T02:25:25Z","timestamp":1792981525730,"version":"4.5.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T00:00:00Z","timestamp":1683676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017964","name":"Tianjin Municipal Health Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017964","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010229","name":"Natural Science Foundation of Tianjin Municipal Science and Technology Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This retrospective study aims to analyze the influence of different treatment modalities on viable intrauterine pregnancy and to summarize the clinical features of heterotopic pregnancy (HP) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>All patients diagnosed with HP between January 2012 and December 2022 in Tianjin Central Obstetrics and Gynecology Hospital were reviewed retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study diagnosed 65 patients using transvaginal ultrasound (TVS), including two cases of natural pregnancy, seven cases of ovulation induction pregnancy, and 56 cases after <jats:italic>in vitro<\/jats:italic> fertilization and embryo transfer (IVF-ET). The gestational age was 50.2 \u00b1 13.0 days at the time of diagnosis. The most frequent manifestations were abdominal pain (61.5%) and vaginal bleeding (55.4%), while 11 patients (16.9%) had no symptoms before the diagnosis. The primary treatment was expectant and surgical management, including laparotomy and laparoscopic surgery. In the expectant management group, four patients were transferred to surgery due to rupture of ectopic pregnancy or ectopic pregnancy mass gradually enlarged. In the surgical management group, 53 patients underwent laparoscopic surgery, and six underwent laparotomy. The laparoscopic group's mean operation time was 51.3 \u00b1 14.2 min (range: 15\u2013140 min), and the median intraoperative blood loss was 20 mL (range 5\u2013200 mL). In contrast, the laparotomy group's mean operation time was 80.0 \u00b1 25.3 min (range 50\u2013120 min), and the median intraoperative blood loss was 22.5 mL (range 20\u201350 mL). Four patients had postoperative abortions. Sixty-one newborns had no birth abnormalities, and no developmental malformations were discovered after a median follow-up of 32 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Expectant treatment has a high failure rate in HP, and laparoscopic surgery is a safe and effective treatment for removing ectopic pregnancy without increasing the risk of abortion or newborn birth defects.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1166446","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T19:43:59Z","timestamp":1683747839000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":23,"title":["Management of heterotopic pregnancy: clinical analysis of sixty-five cases from a single institution"],"prefix":"10.3389","volume":"10","author":[{"given":"Feng","family":"Ge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengpeng","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,5,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3109\/01443615.2010.522749","article-title":"Heterotopic pregnancy","volume":"31","author":"Talbot","year":"2011","journal-title":"J Obstet Gynaecol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2145937","DOI":"10.1155\/2016\/2145937","article-title":"Spontaneous heterotopic pregnancy: dual case report and review of literature","volume":"2016","author":"Chadee","year":"2016","journal-title":"Case Rep Obstet Gynecol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1093\/oxfordjournals.humrep.a136125","article-title":"Heterotopic pregnancies after in-vitro fertilization and embryo transfer","volume":"10","author":"Marcus","year":"1995","journal-title":"Hum Reprod."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e2570","DOI":"10.1097\/MD.0000000000002570","article-title":"Management of heterotopic pregnancy: experience from 1 tertiary medical center","volume":"95","author":"Li","year":"2016","journal-title":"Medicine."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.1016\/j.ajog.2011.08.013","article-title":"Spontaneous prelabor uterine rupture in a primigravida: a case report and review of the literature","volume":"205","author":"Uccella","year":"2011","journal-title":"Am J Obstet Gynecol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.fertnstert.2006.05.085","article-title":"Heterotopic pregnancy: two cases and a comparative review","volume":"87","author":"Barrenetxea","year":"2007","journal-title":"Fertil Steril."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1067\/mob.2000.103620","article-title":"Cornual heterotopic pregnancy: contemporary management options","volume":"182","author":"Habana","year":"2000","journal-title":"Am J Obstet Gynecol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"317592","DOI":"10.1155\/2012\/317592","article-title":"Diagnosis of heterotopic pregnancy using ultrasound and magnetic resonance imaging in the first trimester of pregnancy: a case report","volume":"2012","author":"Sun","year":"2012","journal-title":"Case Rep Radiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1097\/OGX.0b013e31829cdbeb","article-title":"Clinical diagnosis and treatment of ectopic pregnancy","volume":"68","author":"Alkatout","year":"2013","journal-title":"Obstet Gynecol Surv."},{"key":"B10","doi-asserted-by":"publisher","first-page":"770","DOI":"10.3389\/fendo.2019.00770","article-title":"Fertility and neonatal outcomes of freeze-all vs. fresh embryo transfer in women with advanced endometriosis","volume":"10","author":"Wu","year":"2019","journal-title":"Front Endocrinol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1186\/s12884-016-1171-x","article-title":"Successful selective reduction of a heterotopic cesarean scar pregnancy in the second trimester: a case report and review of the literature","volume":"16","author":"Yu","year":"2016","journal-title":"BMC Pregnancy Childbirth."},{"key":"B12","first-page":"1038","article-title":"Live birth after treatment of a heterotopic cornual pregnancy with fetal intrathoracic KCI. 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