Ruptured Heterotopic Pregnancy Following Spontaneous Conception

Abstract

Heterotopic pregnancy following natural conception cycles is a rare event, estimated at one in 30,000 pregnancies. This infrequent phenomenon leads to significant morbidity and potential mortality if not promptly diagnosed. We present the case of a 29-year-old with no identifiable risk factors who presented with hemoperitoneum and hypotension. The patient had a visualized intrauterine pregnancy (IUP) and a marked amount of free fluid on transvaginal ultrasound. At the time of diagnostic laparoscopy, a ruptured left tubal pregnancy was identified. This case highlights that diagnosis of an IUP does not exclude a simultaneous heterotopic pregnancy even in patients for whom no identifiable risks factors can be found. Similarly, diagnosis of an IUP should not lead to delay in treatment of hemoperitoneum.

J Clin Gynecol Obstet. 2020;9(3):70-72
doi: https://doi.org/10.14740/jcgo673