Affiliation:
1. Post Graduate Student, MGM Hospital for Women and Children Sector 4E Kalamboli 410218.
Abstract
A spontaneous heterotopic pregnancy is a rare obstetric entity which can be life threatening if early
diagnosis is missed. There is co-existing intra uterine and extra uterine pregnancy, most often tubal and
rarely cervical or ovarian. It is extremely rare in spontaneous conception but incidence is increasing with the use of ART’s. Early
diagnosis is difcult probably because of the lacking clinical symptoms. It usually presents as a ruptured ectopic pregnancy.
Timely diagnosis and intervention is of utmost importance to prevent maternal morbidity and mortality. Abdominal pain,
swelling, peritoneal irritation, enlarged uterus, vaginal bleeding, pallor, tachycardia, features of shock may be a few presenting
features. With the advances in technology, transvaginal ultrasound proves to be a great diagnostic tool in early diagnosis of
heterotopic pregnancy. Serum beta-hcg levels is of importance. Intervention can be medical or surgical depending on the
hemodynamic condition of the patient and the viability of the intrauterine pregnancy. Heterotopic pregnancy is an unusual
diagnosis and so is often ignored in the presence of an intrauterine pregnancy. But as it can prove to be life threatening so its
diagnosis as a differential should always be kept in mind. Early diagnosis and prompt and effective treatment can save a life or
two!