[Heterotopic pregnancy].

Area of Science:

• Reproductive Medicine
• Gynecology
• Obstetrics

Background:

• Heterotopic pregnancy, a simultaneous intra-uterine and extra-uterine gestation, is rare, occurring in 1 in 20,000-30,000 pregnancies.
• While often associated with assisted reproduction techniques, spontaneous cases occur.
• This report details a rare case of spontaneous heterotopic pregnancy.

Observation:

• A 32-year-old woman presented with hypovolemic shock and acute abdomen following a D&C for a blighted ovum.
• Transvaginal ultrasound revealed hemoperitoneum and an adnexal mass suggestive of a gestational sac with an embryo.
• Emergency laparotomy identified a ruptured left cornual ectopic pregnancy.

Findings:

• The patient underwent left cornual resection due to a ruptured ectopic pregnancy.
• Approximately 600 cc of hemoperitoneum was found.
• The patient had an uneventful postoperative recovery.

Implications:

• Heterotopic pregnancy, though rare, must be considered in the differential diagnosis of acute abdomen in women of reproductive age.
• The increasing incidence of assisted reproduction techniques may contribute to a higher prevalence of heterotopic pregnancies.
• Prompt diagnosis and surgical intervention are crucial for managing life-threatening complications like rupture and hemorrhage.