Abstract:

The incidence of heterotopic pregnancy（HP） is low and the clinical manifestations is lack of specificity. It can be accompanied with abdominal pain, irregular vaginal bleeding and so on, as common ectopic pregnancy. Some patients do not even have any symptoms, and due to the existence of the sac of intrauterine pregnancy, it is easy to ignore the ectopic gestational sac, so the early diagnosis is difficult, often misdiagnosed as early abortion. Review the data of the transplant cycle in our center in the past 5 years, included 41 596 transfered cycles, only 1 heterotopic cervical pregnancy patient was admitted in 2020. The patient had multiple uterine cavity operations in the past and underwent multiple intrauterine adhesions separation. The fresh cycle was cancelled due to thin endometrium. Later, we performed frozen-thawed embryo transfer，thawed and transferred 2 cleavage-stage embryos. Due to repeated irregular vaginal bleeding after transplantation, the patient was admitted to the hospital as a "threatened abortion" in the early emergency department for fetal protection treatment. Later, B-ultrasound confirmed that it was a heterotopic cervical pregnancy. The patient had a strong desire to retain the intrauterine pregnancy, and underwent conservative treatment of fetal reduction (twice), and finally delivered a child. It is suggested that the complex pregnancy is easy to be missed and misdiagnosed, and the diagnosis should be made as early as possible. If the condition is stable and the gestational age is small, fetal reduction surgery can be regarded as an effective treatment.

Key words: Heterotopic pregnancy, Cervical pregnancy, Fetal reduction surgery, Reproductive technology, assisted, Case reports