Coexisting ectopic and intrauterine pregnancies: a case report

Area of Science:

• Reproductive Medicine
• Obstetrics & Gynecology

Background:

• Simultaneous intrauterine and extrauterine pregnancies are rare and diagnostically challenging.
• Diagnosis often relies on high suspicion, especially in assisted reproductive treatment (ART) cases, or predisposing factors like tubal pathology.
• It can be an incidental finding in emergency settings for patients presenting after abortion.

Observation:

• A 40-year-old multigravida presented to the emergency room with a right ectopic pregnancy.
• The patient was diagnosed with coexisting extrauterine and intrauterine pregnancies.
• She underwent a partial right salpingectomy and an elective abortion.

Findings:

• Coexisting ectopic pregnancy should be suspected in patients with acute pelvic pain, even with a confirmed intrauterine pregnancy.
• This suspicion is heightened in patients undergoing ART.
• For patients with early gestation (<4 weeks) following spontaneous or elective abortion, coexisting ectopic pregnancy must be considered in the differential diagnosis.

Implications:

• Failure to diagnose coexisting ectopic pregnancy can lead to severe maternal morbidity and mortality.
• Early and accurate diagnosis is critical for appropriate management and improved patient outcomes.
• Enhanced vigilance is required in specific patient populations, including those undergoing ART or presenting post-abortion.