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. 2009 Dec 21:2:9369.
doi: 10.1186/1757-1626-2-9369.

Acute presentation of a heterotopic pregnancy following spontaneous conception: a case report

Sameer Umranikar  1 , Aarti Umranikar, Junaid Rafi, Pauline Bawden, Shalini Umranikar, Ben O'Sullivan, Adam Moors
Affiliations

Acute presentation of a heterotopic pregnancy following spontaneous conception: a case report

Sameer Umranikar et al. Cases J. .

Abstract

Spontaneous heterotopic pregnancy is a rare clinical condition in which intrauterine and extra uterine pregnancies occur at the same time. It can be a life threatening condition and can be easily missed with the diagnosis being overlooked. We present the case of a 40 year old patient who was treated for a heterotopic pregnancy. She had a transvaginal ultrasound because of a previous ectopic pregnancy and an intrauterine gestational sac was seen with false reassurances. The patient presented acutely with a ruptured tubal pregnancy and this was managed laparoscopically. The ectopic pregnancy was not suspected at her initial presentation. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.

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Figures

Figure 1
Figure 1
Transvaginal ultrasound of uterus showing an irregular intrauterine gestational sac of approximately 8 weeks.
Figure 2
Figure 2
Transvaginal ultrasound showing left adnexal mass containing gestational sac with fetal pole.
Figure 3
Figure 3
Laparoscopic findings of left tubal ectopic pregnancy in the isthmic area of the left fallopian tube with hemoperitoneum.
Figure 4
Figure 4
Laparoscopic left salpingectomy being undertaken.
See this image and copyright information in PMC

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