Spontaneous Heterotopic Pregnancy: A Case Report of a Rare and Critical Obstetric Condition

Heterotopic pregnancy is defined as the concurrent presence of both an intrauterine pregnancy and an extrauterine (typically ectopic) pregnancy. This report presents the case of a 36-year-old female patient who presented to the emergency department with lower abdominal pain. A comprehensive evaluation, including transabdominal and transvaginal ultrasound imaging, revealed a heterotopic pregnancy at an estimated gestational age of six weeks and two days. The ultrasound examination confirmed an intrauterine pregnancy with fetal cardiac activity and a visible fetal pole, as well as a complex vascular lesion in the left adnexal region. Consequently, the patient underwent exploratory laparotomy, including a left salpingectomy, to remove the ruptured left tubal ectopic pregnancy. The ectopic pregnancy was successfully excised, and the intrauterine embryo was preserved. Following this surgical intervention, the pregnancy progressed without complications, culminating in the delivery of a healthy infant at 39 weeks of gestation. With timely and appropriate treatment, a heterotopic pregnancy can result in a successful live birth, yielding favorable outcomes for both mother and child. This case underscores the necessity of considering heterotopic pregnancy even in the absence of risk factors and highlights the importance of multidisciplinary management to achieve optimal outcomes.