A Case of Heterotopic Pregnancy in a Spontaneous Cycle

Objective: Heterotopic pregnancy is a condition in which extrauterine and intrauterine pregnancy coincides. It is encountered very rarely especially in the absence of risk factors. The incidence of heterotopic pregnancy has increased in recent years due to the developments in assisted reproductive technologies (ART). In this case report, we aimed to emphasize the early diagnosis and proper management of heterotopic pregnancies with its mortality and morbidity rates and importance for future fertility. Case: Seven-weeks pregnant women by the date of her last menstrual period had undergone dilatation and curettage (D&C) in another medical center upon the diagnosis of a missed abortus. She applied to the same center after the procedure with the complaint of groin pain and was referred to our tertiary center because of the plateaud β-hCG levels during her follow-up. Her gynecologic and ultrasonographic examination in our clinic suggested an extrauterine pregnancy and the patient underwent a laparoscopy. A tubal ectopic pregnancy was detected at the right tube and a linear salpingotomy was performed. Heterotopic pregnancy diagnosis was confirmed with the pathological examination reports of the samples obtained in D&C and laparoscopy. Conclusion: The heterotopic pregnancy diagnosis should be kept in mind in the differential diagnosis of women who applied with the complaint of abdominal pain in the first trimester of pregnancy especially in pregnancies occurring after ART and should be managed appropriately on time.