Heterotopic Pregnancy Complicated by Rupture: A Case Report

Heterotopic pregnancies are rare occurrences of a simultaneous intrauterine and extrauterine pregnancy.  Ectopic pregnancy is not an uncommon occurrence in women of reproductive age, however heterotopic pregnancy is a rare event, with an incidence of approximately 1/30,000 of natural conceptions. With the increasing use of assisted reproduction techniques, however, the incidence increases significantly.  
The main differential diagnoses for a female patient in the reproductive age group, presenting with per vaginal bleeding, lower abdominal pain or in shock include a ruptured ectopic pregnancy, ovarian cyst accident or miscarriage. A high index of suspicion is necessary to detect heterotopic pregnancies during the early pregnancy period particularly in natural conception.
We present a case of rupture complicating a heterotopic pregnancy in a patient with natural conception.