MCQ – 76907

Correct Answer » D Explanation

Detailed Explanation:

– Clinical Reasoning for the Correct Answer:
– Heterotopic pregnancy = coexistence of intrauterine and extrauterine (ectopic) gestations.
– Most commonly, extrauterine pregnancy is tubal; intrauterine gestation is normal.
– Defined by presence of one gestational sac in uterus and another in fallopian tube (can also rarely be in ovary, cervix, or abdomen).

– Why Option A is Incorrect:
– True incidence in natural conception is much lower (1 in 30,000).
– Incidence rises (~1 in 100) with assisted reproductive technology (ART), but never as high as 10%.
– 10% incidence is a gross overestimation.

– Why Option B is Incorrect:
– Heterotopic pregnancy is much more likely in cases of assisted reproduction (e.g., in vitro fertilization).
– However, occurrence after ART is not exclusive, and this statement does not fully define heterotopic pregnancy.
– It is an associated risk, not the core definition.

– Why Option C is Incorrect:
– Two extrauterine gestational sacs would be termed bilateral ectopic pregnancy, not heterotopic.
– Heterotopic pregnancy specifically refers to one intrauterine and one extrauterine pregnancy.
– No intrauterine gestation = not heterotopic.

– Why Option D is Correct:
– Most precise definition: coexistence of one intrauterine pregnancy and a synchronous tubal (or other ectopic site) pregnancy.
– Reflects the clinical and diagnostic hallmark of heterotopic pregnancy.