Study on diagnosis and management strategies on heterotopic pregnancy: a retrospective study

Figures & data

Table 1. General characteristics and diagnostic information.

Variables	No. (%) of patients
Age, mean ± SD (range), years	30.4 ± 4.9 (21–45)
BMI, mean ± SD (range), kg/m^2	21.7 ± 2.7 (17.3–29.6)
History of abortion, n (%)
0	15 (37.5)
1–2	12 (30.0)
≥3	13 (32.5)
History of tubal surgery, n (%)
Salpingotomy	0
Uni/bilateral tuboplasty	12 (30.0)
Unilateral salpingectomy	5 (12.5)
Bilateral salpingectomy/tubal ligation	7 (17.5)
No	16 (40.0)
Previous PID history	8 (20.0)
Type of infertility, n (%)
Primary	15 (37.5)
Secondary	25 (62.5)
Method of pregnancy, n (%)
Frozen-thawed embryo	15 (37.5)
Fresh non-donor embryo	25 (62.5)
Clinical manifestations, n (%)
Asymptomatic	7 (17.5)
Abdominal pain	9 (22.5)
Vaginal bleeding	12 (30.0)
Abdominal pain and vaginal bleeding	9 (22.5)
Rectal tenesmus	3 (7.5)
Location of EP, n
Tubal (right vs. left)	27 (13 vs. 14)
Interstitial (right vs. left)	7 (5 vs. 2)
Cornual (right vs. left)	6 (3 vs. 3)
Gestational age at symptom onset, mean ± SD (range), days	44.8 ± 8.6 (27–68)
Gestational age on first TVS, mean ± SD (range), days	46.3 ± 7.6 (29–68)
Gestational age at diagnosis, mean ± SD (range), days	49.4 ± 7.6 (29–68)
First TVS suspected HP, n (%)
Yes	29 (72.5)
No	11 (27.5)
Diameters of gestational mass, mean ± SD (range), mm	24.1 ± 11.5 (11.3–56.3)

SD: standard deviation; BMI: body mass index; PID: pelvic inflammatory disease; EP: ectopic pregnancy; TVS: transvaginal sonography; HP: heterotopic pregnancy; IUP: intrauterine pregnancy.

Table 2. Surgical information and clinical outcomes.

Variables	No. (%) of patients
Management of HP, n (%)
Expectant management	11 (27.5)
Surgical management	29 (72.5)
Embryo aspiration management	0
TVS before surgery
IUP, n (%)
Gestational sac	10 (25.0)
Foetal cardiac activity	30 (75.0)
HP, n (%)
Inhomogeneous/hyperechoic mass	23 (57.5)
Gestational sac	6 (15.0)
Foetal cardiac activity	11 (27.5)
Gestational age at surgery day, mean ± SD (range), days	51.0 ± 8.6 (33–67)
Clinical outcomes, n (%)
Term delivery	22 (55.0)
Preterm delivery	4 (10.0)
Abortion	14 (35.0)
Mode of delivery, n (%)
Vaginal delivery	5 (19.2)
Cesarean section	21 (80.8)

IUP: intrauterine pregnancy.

Table 3. Uni- and multi-variable logistic regressions of predictive factors associated with pregnancy outcomes in HP patients.

Variables	N	Pregnancy outcomes		Univariate analyses		Multivariate analyses
		Live birth	Miscarriage	p	Regression coefficient (SE)	p	95% CI
Age (years)
<34	29	20	9	.406	0.144 (0.172)	.846	–0.286 to 0.347
≥34	11	6	5
Method of IVF-ET, n (%)
Frozen-thawed embryo	15	12	3	.130	0.240 (0.155)	.412	–0.175 to 0.416
Fresh non-donor embryo	25	14	11
Gestational age at diagnosis, days
<52	24	15	9	.694	–0.062 (0.158)	.870	–0.288 to 0.338
≥52	16	11	5
Suspected HP at the initial TVS, n
Yes	29	20	9	.406	0.144 (0.172)	.805	–0.470 to 0.368
No	11	6	5
Gestational mass diameter (mm)
<30	30	21	9	.262	0.200 (0.176)	.151	–0.084 to 0.520
≥30	10	5	5
EP foetal heartbeat
Yes	11	7	4	.914	–0.019 (0.173)	.267	–0.600 to 0.173
No	29	19	10
IUP foetal heartbeat
Yes	30	25	5	<.001	0.733 (0.133)	<.001	0.474–1.119
No	10	1	9
HP positions
Adnexal regions	27	18	9	.758	0.051 (0.165)	.655	–0.390 to 0.249
Other regions	13	8	5
Pelvic haemorrhage volume, n
<400 ml	32	22	10	.540	–0.107 (0.172)	.669	–0.504 to 0.328
≥400 ml	8	4	4
Ruptured EP, n
Yes	9	5	4	.333	0.188 (0.191)	.499	–0.645 to 1.294
No	31	21	10
Treatment modality, n
Surgical managements	29	18	11	.512	–0.122 (0.184)	.634	–0.646 to 1.043
Other managements	11	8	3

Data availability statement

The patients’ clinical data that support the findings of this study are not publicly available due to privacy or ethical restrictions.