Abstract
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Describe the definition, incidence, and risk factors associated with heterotopic pregnancy.
Identify key transvaginal sonographic findings that support the diagnosis of heterotopic pregnancy during early gestation.
Discuss management strategies for heterotopic pregnancy and their implications for preservation of the intrauterine pregnancy (IUP).
1. How is a heterotopic pregnancy defined? A. The simultaneous presence of an intrauterine pregnancy (IUP) and an extrauterine pregnancy B. The implantation of two embryos within the uterine cavity C. A multifetal pregnancy resulting from ovulation induction D. An ectopic pregnancy occurring after a failed intrauterine pregnancy
2. Which patient history factor is most commonly associated with an increased risk of heterotopic pregnancy? A. Advanced maternal age B. Assisted reproductive technologies C. Prior cesarean delivery D. Gestational diabetes mellitus
3. Which imaging modality is considered the diagnostic gold standard for early detection of heterotopic pregnancy? A. Transabdominal sonography B. Magnetic resonance imaging C. Transvaginal sonography D. Computed tomography
4. Which sonographic finding supported the diagnosis of an ectopic component in the reported case? A. Absence of a yolk sac within the uterus B. A complex adnexal mass without identifiable embryonic structures C. Free fluid within the cul-de-sac D. A gestational sac with a fetal pole in the right adnexa
5. What Doppler finding is characteristic of active trophoblastic tissue in an ectopic pregnancy? A. Uniform central vascular flow B. Absence of peripheral vascularity C. “Ring of fire” peritrophoblastic flow on color Doppler ultrasound D. Low-resistance uterine artery flow
6. Which surgical intervention was performed to manage the ectopic component while preserving the IUP? A. Laparoscopic right salpingectomy B. Methotrexate therapy C. Expectant management only D. Hysterectomy
7. Which management option should be avoided in heterotopic pregnancy due to the presence of a viable IUP, according to the article? A. Expectant management B. Ultrasound-guided selective embryo aspiration C. Methotrexate therapy D. Laparoscopic salpingectomy
Footnotes
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