Heterotopic pregnancy in a natural conception cycle: A case report

Abstract

Heterotopic pregnancy is defined as the coexistence of intrauterine and extrauterine pregnancy. Estimated incidence in general population is 1:30,000 (for a naturally conceived pregnancy). Incidence among patients with assisted reproductive technology is higher and is around 1:100 to 1:500. These patients are more likely to have spontaneous or medically induced abortion. We report a case of 35year old female G4 P3 L3 with 1 ½ months of amenorrhea presented in causality with pain abdomen and bleeding per vaginal in last 15 days with positive urine pregnancy test (UPT) report. USG shows a small 3 mm size hypoechoic focus with surrounding decidual reaction seen in endometrium– could be a gestational-sac, Left adnexa bulky with free fluid in pouch of douglas and in pelvic peritoneal cavity. Patient underwent laparotomy there was ruptured left tubal pregnancy with hemoperitoneum and left salpingectomy was done, dilation and evacuation of intrauterine pregnancy was done. The diagnosis of heterotopic pregnancy was confirmed on Histopathological report.