Heterotopic pregnancy is a rare event. This type of pregnancy includes simultaneous intrauterine pregnancy and ectopic pregnancy. Because of the high risk of rupture of ectopic pregnancy in this case, the diagnosis of this life-threatening condition is most important. So, this study was performed with aim to introduce a case of heterotopic pregnancy.
Case report: In this article, a 20 years old pregnant woman at 18 weeks of pregnancy with clinical symptoms of pelvic mass with a presumptive diagnosis of malignant ovarian tumor is introduced. Surgical report of the frozen section of pelvic mass detected ectopic pregnancy and after surgery, intrauterine pregnancy continued until the delivery of a healthy baby.
Although heterotopic pregnancy is a rare event, but we should consider the risk of heterotopic pregnancy in all pregnant women. Heterotopic pregnancy in case of lack of attention and inappropriate treatment can lead to emergency and critical situation.

Heterotype pregnancy has been defined as coexistence of intrauterine and ectopic pregnancy. Coexistence of intrauterine and ovarian pregnancy is rare and often occurs in women who use Intra-Uterine Device (IUD) or women under assisted reproductive technology. We report a case who presented abdominal pain and an adenexal mass in ultrasound scanning. Post-operative diagnosis was coexistence of intrauterine and ovarian pregnancy. Case Report: The paitent was a 29 year old woman G4P3 who presented abdominal pain, nausea, vomiting and a four months history of menstrural cessassion and a two months history of spotting. On physical examination, her uterus was in approximatly the 18th week stage of pregnancy. There was abvious tenderness in LLQ. A firm mass estimated to be about 3 cm was palpable. In clinical and paraclinical evaluations she had 17 week intrauterine pregnancy and a left adenexal mass with 7.5 week pregnancy sac without heart bit. Post-operative pathological examination revealed heterotype pregnancy with ovarian pregnancy. Heterotype pregnancy is rare and the vast majority of cases are a coexistence of tubal and intra-uterine pregnancy. Coexistence of intrauterine and ovarian pregnancy is very rare. Probably, the predisposing factor in this patient was the use of IUD. Recently, this has been reported frequently in cases of ovarian heterotype pregnancy. In this patient, ovarian tissue was seen around the pregnancy sac. The most common symptom is abdominal pain followed by delay in menstruation cycle and spotting. Diagnosis of ovarian pregnancy accompanied by intra-uterine pregnancy is difficult. In this situation serial measurment of hcG is not useful, since the intra-uterine pregnancy causes appropriate rise in hcG concentration. On the other hand, ultrasonography may show false negative results in the detection of ectopic pregnancy or make incorrect diagnosis of corpus louteum cyst.

The present experiment was performed to evaluate the effect of feeding ewes with two different feeding levels during mid- and late pregnancy on the performance and behavior of ewes and lambs during 24 hours after birth.In order to test 112 ewes of Zandi singleton breed that were pregnant, they were randomly divided into 4 feeding levels in mid and late pregnancy in 4 treatments and 4 replications (7 repetitions per head).Experimental treatments include: 1- Feeding with 4 cm forage in mid-pregnancy and feeding with 4 cm forage in late pregnancy (4-4), 2- Feeding with 4 cm forage in mid-pregnancy and feeding with 2 cm forage in Late pregnancy (4-2), 3- Forage feeding 2 cm in mid-pregnancy and forage feeding 4 cm in late pregnancy (2-4), 4- Forage feeding 2 cm in mid-pregnancy and forage feeding Were 2 cm in late pregnancy (2-2).According to the results, the weight of ewes and the birth weight of their lambs that used 4 cm forage in mid and late pregnancy had a significant increase compared to other groups (p < 0.05).Lambs born from 4-4 group ewes moved less towards their mother to communicate (p < 0.05).In general, the results of the present experiment showed that feeding ewes in late gestation with four cm of forage could have better performance on ewes and lambs born.

Heterotopic pregnancy (HP) is a rare occurrence in natural pregnancies. However, it can be a life-threatening condition and should be taken into account in all assisted reproductive treatments. Diagnosis and treatment of ectopic pregnancy are challenging issues in patients with HP. Here, we report a rare case of quadruplet HP following an in vitro fertilization-embryo transfer with a viable twin intrauterine pregnancy and ruptured live twin left tubal ectopic pregnancy. A 35-year-old woman (gravida 5, para 1, ectopic pregnancies 2, and abortion 1) was presented to the Emergency Department of Arash Women’s Hospital (Tehran, Iran) in March 2021 with abdominal pain. The patient was at six weeks and five days of pregnancy following in vitro fertilization-embryo transfer. Transvaginal sonography (TVS) revealed a live twin intrauterine pregnancy with a ruptured live twin left tubal ectopic pregnancy. The latter was removed via laparotomy to preserve the intrauterine pregnancy. The patient subsequently delivered a female infant at 38 weeks of pregnancy.

A molar pregnancy is the result of an abnormally fertilized egg or placental tissue expansion. The goal of this research was to investigate the potential linkage between some biochemical tests, antioxidant enzymes, oxidative stress, and fatty acid compositions in patients with a molar pregnancy compared with healthy pregnancy subjects. An observational case-control study was conducted in Mosul, Iraq. In this study, 141 women participated, and they were split into three group: 45 patients with molar pregnancy, 47 women with healthy pregnancy, and 49 healthy control women. Antioxidant enzymes, lipid peroxidation, hCG, ALP, trace elements, and fatty acid compositions were all investigated. The results revealed that MAD and hCG levels were increased in molar pregnancy compared with healthy pregnancy, while paraoxonase and GSH levels were decrease in molar pregnancy women than in healthy pregnant women. Likewise, the results showed that the increase of saturated fatty acids in molar pregnancy women was greater than in healthy pregnancy. This study found a significant rise in oxidative stress and poor monounsaturated and polyunsaturated fatty acid status in molar pregnancy as well as increased saturated fatty acids.

Heterotopic pregnancy is a rare form of pregnancy and could accompany with maternal mortality and morbidity. Most of the cases have a history of assisted reproductive technology or other risk factors like history of ectopic pregnancy and pelvic inflammatory disease. In this article we report a case of heterotopic pregnancy in a 39 year old woman with spontaneous pregnancy and without any risk factor whose heterotopic pregnancy diagnosed before rupture of ectopic pregnancy and surgery.

Abdominal pregnancy is 1 in 10000 live births and advanced abdominal pregnancy is rare. Abdominal pregnancy is associated with high morbidity and mortality with the risk for death 7 to 8 times greater than tubal ectopic pregnancy and 90 times greater than intrauterine pregnancy. In this article a case of advanced abdominal pregnancy is reported. Case: The patient was a 35 year’s old (G4P3) woman presented with undelivered pregnancy after two years. After diagnostic procedures laparatomy was done. During the operation, fetus adhesion to the omentum was released. A 9 kg calcified fetus was delivered. Then the placenta and left adnex was removed completely. Regarding the high mortality rate of abdominal pregnancy, in every pregnancy specially in the precence of it’s risk factors (such as PID, history of ectopic pregnancy, history of infertilitry and using drugs to induce ovulation, IVF, prior tubal surgery and …) and also suspicious symptoms, this probability and early intervention must be considered.

The purpose of the present study was to evaluate the relationship between physical activity before and during pregnancy and identifying the most important period predictor of physical activity during pregnancy. 137 pregnant women participated voluntarily in the study. Information about exercise during eight and one year before pregnancy and during first، second and third trimesters of pregnancy were recorded through interview. Findings were analyzed using Pearson correlation and linear regression methods. Significant level was set at p < 0. 05. Results indicated a significant positive correlation between exercise during all periods before pregnancy and during pregnancy (p=0. 001). Moreover، one year before pregnancy was stronger predictor of exercise during pregnancy. In order to motivating women to participate in exercise during pregnancy، performing of exercise specially one year before pregnancy، is recommended.

Thyroid autoimmunity may be linked to infertility, in both thyrotropin (TSH)-dependent and TSH-independent fashion. The aim of the present study was to assess this presumed reciprocal relationship of thyroid autoimmunity and pregnancy.
TSH and antithyroid peroxidase autoantibodies (anti-TPO) were evaluated retrospectively over an eight-year period in 444 Greek women who had previously none or at least one pregnancy (>28 weeks). Statistics were done with analysis of covariance (ANCOVA) and the Chi square test.
Thyrotropin was higher in women with one pregnancy and lower in those with two or more pregnancies compared to women with no pregnancies. Furthermore, significantly more women with no pregnancies were anti-TPO (), compared to women with one or those with at least two pregnancies.
Because pregnancy might contribute to the development of thyroid autoimmunity, women should be monitored for development of thyroid autoimmunity long after their pregnancies, even after an uneventful first conception, pregnancy and delivery of a live infant.

When a fertilized ovum implants outside of the uterine cavity is known as ectopic pregnancy. Bilateral Tubal Ectopic Pregnancy is one of the most uncommon types of ectopic pregnancies and its incident is higher in women using reproductive techniques and early detection of that is extremely important because of associated morbidity and mortality. A 33 years woman with previous history of ectopic pregnancies was admitted due to amenorrhea and abdominal pain. She had undergone IUI 28 days before admission. In Transvaginal ultrasound we found heterogeneous masses in both adnexa, suspicious for bilateral ectopic pregnancies. Color Doppler ultrasound exam showed peripheral vascularity in both masses. Surgical findings following laparoscopic bilateral salpingectomy were two non ruptured ectopic pregnancy masses in ampullary parts of both fallopian tubes. Histopathological findings confirmed the diagnosis of bilateral ectopic pregnancies. In women with history of previous ectopic pregnancy and infertility, even if unilateral ectopic pregnancy is considered, checking contralateral adnexa carefully by TVS to exclude bilateral ectopic pregnancy is essential and could prevent physicians from facing urgent challenges and decrease the risk of maternal morbidity and mortality.