Heterotopic quadruplet pregnancy: conservative management with ultrasonographically-guided KCl injection of cornual pregnancy and laparoscopic operation of tubal pregnancy.

OBJECTIVE: To discuss a case of heterotopic cornual and tubal pregnancy managed with transvaginal potassium chloride (KCl) injection of cornual pregnancy and laparoscopic operation of tubal pregnancy.

METHODS: The subject was a 30-year-old woman with twin pregnancy with a left cornual and a tubal pregnancy. The heterotopic cornual pregnancy was treated with ultrasonographically-guided transvaginal injection of KCl into the thorax of ectopic fetus, and the tubal pregnancy was treated with laparoscopic left salpingectomy.

RESULTS: The woman was discharged on the 6th postoperative day. After complete ablation of the cornual and tubal pregnancy, the subject had no complications or side effects for the duration of her pregnancy up to the 37th week. Elective cesarean section was performed at 37 weeks and allowed the birth of 2 boys weighing 2,500 and 2,000 g and of normal development.

CONCLUSIONS: A minimally invasive approach should be considered in a hemodynamically stable patient to treat a first-trimester heterotopic pregnancy to maintain the intrauterine pregnancy with a satisfactory outcome.