Anaesthesia considerations and management in case of first trimester heterotopic pregnancy undergoing a laparoscopic ectopic excision

Abstract

Heterotopic pregnancy is a presence of intrauterine and extra-uterine gestation concurrently. It might be rare but possess great challenge for an anaesthetist as both maternal and foetal safety are at risk. We report a case of 28 years primigravida diagnosed as heterotopic pregnancy and shifted for an emergency laparoscopic ectopic excision under General anaesthesia. Our primary concern for maternal and foetal safety for undergoing surgery in first trimester pregnancy was achieved by Meticulous attention to preoperative counselling, airway management, aspiration prophylaxis, haemodynamic stability, choice of anaesthesia and anaesthetic drugs which have minimal impact on utero-placental perfusion and uterine relaxation. On follow up the patient delivered a healthy full term live female child weighing 2.7 kg by elective cesarean section.