Heterotopic pregnancy in a natural conception cycle presented as a ruptured ectopic pregnancy: case report

Background: Heterotopic pregnancy is defined as an intrauterine pregnancy that coexists ectopically with another pregnancy. It is a rare event, in particular in patients not being treated for infertility. Our objective is to report the case of a patient who did not undergo in vitro fertilization or any other type of infertility treatment. The patient presented a heterotopic pregnancy as acute abdomen. Clinical case: We report the case of a 21-year-old female who was referred to the General Hospital of Mexico with intense abdominal pain in both lower quadrants and hypovolemic shock symptoms. Emergency pelvic ultrasonography demonstrated a ruptured ectopic pregnancy along with an intrauterine pregnancy of 7.4 weeks gestation. For that reason, the patient underwent urgent exploratory laparatomy. Conclusions: Heterotopic pregnancy is a rare event in the natural conception cycle. To elaborate the diagnosis, high clinical suspicion and specific diagnostic studies are necessary.