Objective
T
o rep
ort a case
of a triplet heter
ot
opic caesarean scar pregnancy (CSP) with tw
o gestati
onal sacs implanted in the caesarean scar after in vitr
o fertilizati
on-embry
o transfer.
Design
Case report.
Settings
Private reproductive medicine center and obstetric department of a university hospital.
Patient(s)
A 31-year-old woman with previous caesarean section affected by secondary infertility related to male azoospermia.
Intervention(s)
In vitro fertilization-embryotransfer followed by early ultrasound diagnosis of heterotopic CSP and selective embryo reduction performed by transvaginal ultrasound-guided potassium chloride and methotrexate injection in the ectopic gestational sacs.
Main outcome mesure(s)
Successful pregnancy outcome.
Result(s)
An ongoing intrauterine pregnancy with a live birth after successful management of ectopic gestational sacs.
Conclusion(s)
Triplet heterotopic CSP with two ectopic gestational sacs may occur after IVF-ET and, to our knowledge, this is the first time such a complication has been reported. Ultrasound is the main tool allowing early diagnosis of this condition, and the injection of potassium chloride and methotrexate is a safe and efficacious treatment method. The gynecologist managing early pregnancy should be aware of the possibility of CSP, and patients must be appropriately counseled about the different treatment options.