Monika Gupta can’t thank her stars and her doctor enough. The 36 year old housewife was successfully treated for one of the rarest diagnoses – Heterotopic Pregnancy-at Paras Hospitals, Gurgaon.
Heterotopic Pregnancy is an extremely rare condition as it exists only in 1/30,000 cases. Recent data indicates that the rate is higher in assisted reproduction (IVF) and is approximately 1 in 7000 and as high as 1 in 900 with ovulation induction. However the aspect that makes this case rarer is the fact that Monika did not opt for any IVF procedure and her condition was natural. Such cases require a high index of suspicion for early and timely diagnosis and still remain a diagnostic challenge for clinicians.
Monika shares, “One month back, I had gone through a surgical termination of pregnancy at a private nursing home. Post the procedure I continued to experience abdominal pain and bleeding .The pain was affecting my everyday life and it was difficult for my treating doctors at the nursing home to diagnose the reasons for the same.”
She further adds, “ I went through 3 ultrasounds at different hospitals and even got admitted in the government hospital where I received intravenous fluids with antibiotics, but my situation did not improve. The doctors then referred me to a tertiary care centre.”
At Paras Hospitals, Gurgaon the ultrasound scan revealed a localized mass, the size of a tennis ball, in the fallopian tube.
According to Dr. Nupur Gupta, “The beauty of the case is that even post the surgical termination, Monika tested positive for pregnancy (serum Beta HCG 347 mIU/ml). With a provisional diagnosis of a tubo ovarian mass lesion, an investigative laparoscopic surgery was performed which revealed a mass with clotted blood, enlarged tube with a small fetus with adhesions between uterus, bladder and bowel. As part of the surgical treatment, the tube had to be removed along with blood clots and the fetus. Medically, this is known as “Heterotopic pregnancy” where pregnancy can happen at two locations simultaneously (uterus as well as the tube). This is an exceptionally rare case of missed tubal pregnancy diagnosis, which if left untreated can lead to complications such as haemorrhage or even death.”
Post surgery, Monika has recovered well and her pain started to subside after few days of surgery.
“My family thought that my symptoms were psycho-somatic and my doctors at the nursing home and the government hospital could not understand or diagnose the reason for my pain. It was Dr. Nupur Gupta who understood my issues and has given her best to ensure that I am pain free. I shall always be indebted to her.”
Dr. Nupur Gupta, Consultant and Unit Head, Obstetrics & Gynaecology at Paras Hospitals, Gurgaon specializes in handling high risk pregnancies, ectopic pregnancies and has numerous complex cases to her credit. Her take-home message for all women is , “Never ignore pelvic pain and bleeding in your reproductive age. Always consult a specialist, if you detect any abnormality in your body.”