Think Heterotopic: A Case Report of Heterotopic Pregnancy Detected on Thorough Ultrasonography

Tng Chang Kwok, George Morgan


We present a case report of heterotopic pregnancy picked up on thorough ultrasonography in a clinically stable 22-year-old patient with low risk factors. Heterotopic pregnancy is a rare obstetrics phenomenon and carries a significant maternal morbidity and mortality due to the risk of rupture of the ectopic pregnancy. Clinicians and sonographers tend to be lulled into a false sense of security when an intrauterine gestation sac is seen. This results in inadequate inspection of the adnexae and remaining structures during ultrasonography despite a strong initial clinical suspicion of ectopic pregnancy. Hence, a thorough ultrasonography and holistic approach is needed in managing these patients, especially when there is a high suspicion of ectopic pregnancy or in the presence of pelvic free fluid even when an intrauterine pregnancy is identified. A new dictum Think ectopic. If intrauterine gestation is seen, think heterotopic needs to be adopted.

J Med Cases. 2012;3(5):326-328


Heterotopic pregnancy; Ultrasonography; Ectopic; Holistic

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