Clinical Analysis of Heterotopic Pregnancy Misdiagnosed as Threatened Abortion

WU Pengwen; LI Bing; NIU Sanqiang; DU Ningning

doi:10.3969/j.issn.1002-3429.2025.07.005

Abstract：Objective To explore the clinical characteristics and differential diagnosis of heterotopic pregnancy in or-der to reduce misdiagnosis and mistreatment.Methods The clinical data of a patient with misdiagnosed heterotopic pregnan-cy admitted in October 2023 were retrospectively analyzed,and the relevant literature was reviewed.Results More than 30 d after in vitro fertilization and embryo transfer,the patient presented with intermittent cryptic pain in the lower abdomen for 2 d,without obvious vaginal bleeding and fluid flow.Threatened abortion was initially diagnosed after B-ultrasound examina-tion in another hospital,and no relief was achieved after symptomatic treatment.After admission to our hospital,vaginal ultra-sonography indicated intrauterine and extrauterine heterotopic pregnancy,and the misdiagnosis lasted 2 d.After diagnosis,laparotomy was performed on the left fallopian tube and gestational excision.Postoperative pathology indicated pregnancy in the left fallopian tube,and the patient was cured and discharged.The delivery has now been successful.Conclusion The occur-rence of heterotopic pregnancy is relatively rare,and due to various clinical manifestations and lack of specificity,it is prone to misdiagnosis or missed diagnosis.In clinical practice,when patients with in vitro fertilization and embryo transfer or ovula-tion-assisted pregnancy have symptoms such as abdominal pain and vaginal bleeding,it is necessary to develop new ideas,consider the possibility of heterotopic pregnancy,timely conduct detailed ultrasound scanning of the uterus and the accessory area,and conduct dynamic assessment,in order to reduce or avoid the early misdiagnosis of heterotopic pregnancy.