Heterotopic pregnancy

Case contributed by kely mendez


The patient is a G1P1 presenting with abdominal pain and cramping. The pregnancy test is positive with no history of pelvic inflammatory disease or prior ectopic pregnancy.

Patient Data

Age: 35 years
Gender: Female

Ultrasound was obtained to rule out an ectopic pregnancy.

Ultrasound demonstrates two gestational pregnancies, both with fetal cardiac activity. The intrauterine gestational sac can be seen with a decidual reaction circumferentially around it. The fetal crown-rump length is 5mm, consistent with 6-week gestation and compatible with the patient's LMP. There is also a perisac hematoma of about 8cc.

The other gestational sac is located in the right adnexal region, consistent with ectopic pregnancy.

No free fluid is seen in the cul-de-sac.

Case Discussion

This case illustrates a heterotopic pregnancy, which occurs when both an extra-uterine (ectopic pregnancy) and an intrauterine pregnancy happen simultaneously.

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