Heterotopic pregnancy

Abstract

Heterotopic pregnancy is defined as a condition when intrauterine and extra uterine pregnancy occur simultaneously. It is a life-threatening condition that requires immediate and accurate diagnostics and treatment. It is difficult to diagnose and easily missed. The incidence in the general population is estimated to be 1 in 30,000. With the advent of Assisted Reproduction Techniques (ART) and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required. We present a case of a 30-year-old secondi gravida with history of one spontaneous abortion and pelvic inflammatory disease, who conceived spontaneously and at her fifth week of amenorrhea, was presented to the emergency department with acute pain in lower abdomen, moderate vaginal bleeding and weakness. Laboratory tests and transvaginal ultrasonography revealed the diagnosis of heterotopic pregnancy.