Why is a heterotopic pregnancy dangerous for the expectant mother?

What is a heterotopic pregnancy?

A heterotopic pregnancy is the simultaneous development intrauterine (IUG) and ectopic pregnancy (EUG). It is a special twin pregnancy because one embryo is usually implanted in the uterus and the other is placed outside of it, usually in the fallopian tube. But how can it develop outside the uterus? When it finds a place to nest, it develops its trophoblast (the outer layer of cells that surrounds the embryo and becomes the placenta). It then makes anastomoses (connections) with the maternal circulatory system, allowing it to grow. In most cases, it does not go beyond the embryonic stage.

The causes of heterotopic pregnancy

Although heterotopic pregnancies are very rare, cases have increased in recent years. For two reasons :

– In particular, the increase in STIs (Sexually Transmitted Infections). the chlamydia because it damages the trunk. Damage to it creates a narrowing and thus an obstacle for the egg cell, which was naturally fertilized in the fallopian tube but should have migrated into the uterine cavity.
– The increase in pregnancies through PMA (Medical Assisted Procreation), which encourages the birth of twins.

Symptoms of a heterotopic pregnancy

The symptoms of a heterotopic pregnancy are those of an ectopic pregnancy, namely:

– Stomach pain
– Unusual bleeding
– Sore breasts
– Lower back pain
– Cramps in the abdomen or pelvis

These symptoms can mean something else entirely, but if you notice them, don’t hesitate to contact a doctor. It is better not to remain in doubt and to do everything possible to reassure you and, if necessary, to intervene as soon as possible.

Diagnosis of a heterotopic pregnancy

A heterotopic pregnancy is difficult to diagnose and is confirmed by ultrasound. If there is an outpouring of fluid (blood) in the pelvis and possibly an abnormal mass in the laterouterum, the pregnancy is likely heterotopic. But to see it, the ectopic pregnancy must be far enough advanced. However, this pathology must be detected early in order to preserve the later fertility of the patient as well as the intrauterine pregnancy.

Heterotopic pregnancy is dangerous for the pregnant woman because the trophoblastic vessels invade the fallopian tube, which can lead to rupture, which can lead to internal bleeding l’hypervascularization (meaning from an organ whose vessels are abnormally developed) of this extrauterine implantation. Therefore, action must be taken as soon as possible!

Terminate a heterotopic pregnancy

A heterotopic pregnancy must be terminated. As a reminder, the embryo implanted outside the uterus does not usually reach the fetal stage. An ectopic pregnancy (tubal pregnancy) can therefore end on its own. If necessary, health professionals can proceed with the removal of this pregnancy through laparoscopy to avoid internal bleeding.

The embryo implanted in the uterus is not in danger. Therefore, specialists do not try to interrupt his development, although laparoscopy can still be risky for him. The pregnancy is then continued under special supervision.

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