Laparoscopic treatment of a spontaneous ovarian heterotopic pregnancy

Spontaneous heterotopic pregnancies are uncommon, and ovarian implantations are even more unusual. Clinical symptoms, serial human chorionic gonadotropin levels and the presence of an intrauterine pregnancy on ultrasound are not reliable to diagnose a heterotopic pregnancy. A 27-year-old Gravida 2 Para 1 presented with a complaint of right lower quadrant sharp, cramping pain associated with nausea and vomiting. Ultrasound demonstrated an intrauterine pregnancy and a right adnexal mass. The right adnexal mass had a gestational sac with a fetal pole and positive fetal heart activity. A laparoscopic ovarian cystectomy was performed with preservation of the corpus luteum. A discussion of conservative versus radical treatment of the heterotopic pregnancy is presented.