Think Heterotopic: A Case Report of Heterotopic Pregnancy Detected on Thorough Ultrasonography

Abstract

We present a case report of heterotopic pregnancy picked up on thorough ultrasonography in a clinically stable 22-year-old patient with low risk factors. Heterotopic pregnancy is a rare obstetrics phenomenon and carries a significant maternal morbidity and mortality due to the risk of rupture of the ectopic pregnancy. Clinicians and sonographers tend to be lulled into a false sense of security when an intrauterine gestation sac is seen. This results in inadequate inspection of the adnexae and remaining structures during ultrasonography despite a strong initial clinical suspicion of ectopic pregnancy. Hence, a thorough ultrasonography and holistic approach is needed in managing these patients, especially when there is a high suspicion of ectopic pregnancy or in the presence of pelvic free fluid even when an intrauterine pregnancy is identified. A new dictum ‘Think ectopic. If intrauterine gestation is seen, think heterotopic’ needs to be adopted. J Med Cases. 2012;3(5):326-328 doi: https://doi.org/10.4021/jmc779w