Spontaneous Heterotopic Pregnancy: As One of the Most Challenging Emergency Cases in Obstetrics

Abstract

Spontaneous Heterotopic Pregnancy “SHP”: is defined as the presence of multiple gestations, in which, intrauterine and extrauterine pregnancy occur simultaneously, it is a life-threatening condition that requires immediate and accurate diagnosis and treatment. Here, we present a case of a 38-year-old pregnant female who conceived spontaneously, at her sixth week of gestation, was presented to the emergency department with acute pain in lower abdomen and minimal vaginal bleeding, she underwent previous falsely reassuring ultrasound imaging for two times and her symptoms were ignored until the diagnosis was finally made by us. Pelvic ultrasound showed evidence of an IUP and a left adnexal mass, raising suspicion for a heterotopic pregnancy. An urgent exploratory laparotomy and a left salpingectomy were performed, postoperative, the patient recovered well but she had an early pregnancy loss at 8 weeks of gestation. Clinicians should keep in mind that confirmation of an Intrauterine Pregnancy (IUP) should not preclude the existence of a heterotopic pregnancy.