Heterotopic Pregnancy (Ruptured) With Subchorionic Bleeding: A Case Report

Abstract

Background: Heterotopic pregnancy is a rare complication. In this uncommon event both extra uterine and intrauterine pregnancy coexists. Heterotopic pregnancy could be potentially fatal without early surgical intervention and management.

Case presentation: We report a rare of combined ectopic pregnancy. A 44-year-old G8 P6 8 weeks pregnant woman with history of previous twin miscarriage presented with severe lower abdominal pain, vomiting and bilateral renal angle tenderness. An emergency pelvic and transabdominal ultrasonography aided in the diagnosis of heterotopic pregnancy. Emergency exploratory laparotomy revealed massive damage to surrounding tissues so a total hysterectomy was performed to prevent further complication and mortality.

Conclusion. Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Timely surgical intervention will help lower obstetric morbidity and mortality.