Title : Spontaneous heterotopic pregnancy: A case report
Abstract:
Heterotopic pregnancy, the coexistence of intrauterine and extrauterine gestations, is a rare but life-threatening condition that poses significant diagnostic challenges. It often goes undetected, especially in natural conceptions where the suspicion for ectopic pregnancy may be overlooked upon confirmation of an intrauterine gestation.
We report a rare and clinically significant case of spontaneous heterotopic pregnancy in a 38-year-old gravida 2 para 1 woman with no risk factors or history of assisted reproduction. She presented with abdominal pain and vomiting at 11 weeks and 6 days of gestation. Transvaginal ultrasound revealed a live intrauterine pregnancy coexisting with a right adnexal ectopic pregnancy with cardiac activity. An emergency exploratory laparotomy and right salpingectomy were performed. The intrauterine pregnancy was preserved, and the patient had an uneventful antenatal course, ultimately delivering a healthy baby via emergency cesarean section at term.
This case underscores the importance of maintaining a high index of suspicion for heterotopic pregnancy, even in natural conceptions. Early detection through thorough clinical evaluation and imaging can significantly improve maternal and fetal outcomes.
