Case of heterotopic cervical pregnancy and total placenta accreta after artificial cycle frozen‐thawed embryo transfer

• Published in: Reproductive medicine and biology Vol. 17; no. 1; pp. 89 - 92
• Main Authors: Saito, Kazuki, Fukami, Maki, Miyado, Mami, Ono, Ichiro, Sumori, Keijiro
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01-01-2018; John Wiley and Sons Inc; Wiley
• Subjects: Abortion; artificial cycle; Case Report; Case Reports; cervical heterotopic pregnancy; Cesarean section; Embryo; Embryo transfer; Embryos; Fetuses; frozen‐thawed embryo transfer; Gestation; Health aspects; Hemorrhage; Human papillomavirus; Hysterectomy; Miscarriage; Placenta; placenta accreta; Pregnancy; Pregnancy complications; Pregnancy, Ectopic; progesterone; Reproductive technologies; Supplements; Ultrasonic imaging; Japan; frozen‐thawed embryo transfer; cervical heterotopic pregnancy; placenta accreta; artificial cycle; progesterone
• ISSN: 1445-5781; 1447-0578
• DOI: 10.1002/rmb2.12064

Case
A 39‐year‐old woman presented with a genital hemorrhage at 5 weeks of gestation after an artificial cycle double frozen‐thawed embryo transfer. She was diagnosed with a cervical heterotopic pregnancy. Although hormone supplementation was discontinued to terminate the pregnancy at 5 weeks of gestation, the intrauterine and cervical gestational sacs continued to develop.
Outcome
The cervical gestational sac was surgically removed and the intrauterine pregnancy continued uneventfully, except for vasa previa. At 36 weeks of gestation, the patient underwent a cesarean section and gave birth to a healthy female infant. At the delivery, massive bleeding occurred and a hysterectomy was performed due to total placenta accreta.
Conclusion
This case provides a novel example of a near‐term delivery after a cervical heterotopic pregnancy and emphasizes the need for intensive care, even after the successful management of a cervical pregnancy. Most importantly, the present case implies a possible link between hormonal withdrawal and abnormal placentation.