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Case Reports
. 2025 Jan 6;17(1):e77020.
doi: 10.7759/cureus.77020. eCollection 2025 Jan.

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

Merfat M Flmban  1 , Reem H Mohammed  1 , Hanan M Alshehri  1 , Suhad A Aljuhani  2 , Rahaf F Baamer  1 , Nouf A Alsahafi  3 , Alaa M Aljedani  1
Affiliations
Case Reports

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

Merfat M Flmban et al. Cureus. .

Abstract

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.

Keywords: ectopic pregnancy; heterotopic pregnancy; laparoscopy; salpingectomy; spontaneous pregnancy.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Transabdominal ultrasonography image of uterus shows a single empty gestational sac seen in the uterine cavity.
Figure 2
Figure 2. Transabdominal ultrasonography image of uterus shows a single gestational sac seen in the uterine cavity containing single viable fetal pole, corresponding to six weeks and two days, with a crown-rump length of 0.49 cm.
Figure 3
Figure 3. Transabdominal ultrasonography image of uterus shows a left adnexal mass with left adnexal vascular lesion (complicated left ectopic gestation).
See this image and copyright information in PMC

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