Nighat Sultana.
Heterotopic Pregnancy - a rare spontaneous case
Pak Armed Forces Med J Mar 2006;56(1):87-8.
Combined Military Hospital Multan

An 18-years old primigravida, married for the last three months presented at 7 weeks gestational age with complaints of sudden onset of severe pain in lower abdomen and vaginal spotting for the last six hours. Her menstrual cycle was regular. This was a planned spontaneous conception. Her pregnancy test was positive, but there was no ultrasonic evidence available. On examination she was extremely pale and sweating. The blood pressure was 70/40 mmHg, and pulse 120/min. Cervical os was closed with slight brownish vaginal discharge. There was fullness in all fornices and uterus size could not be assessed due to marked tenderness. She was immediately resuscitated with intravenous fluids. Ultrasound revealed ruptured ectopic pregnancy. Her hemoglobin was 5 grams%. On emergency laparotomy, there was 3 liters of fresh and clotted blood in the peritoneal cavity. Both the tubes were intact but right was slightly swollen and bleeding, it seems like tubal abortion. Right salpingectomy was done. Specimen sent for pathologic examination. Both ovaries were normal looking and uterus was bulky. Haemostasis was secured and abdomen was closed. About three weeks postoperatively she presented with persistent nausea and vomiting, on thorough examination ultrasound revealed normal intrauterine gestation of 10 weeks consistent with her LMP. She was followed up regularly for fetal growth, and any other complications. She went into spontaneous labour at term and delivered a live normal male baby of 2.8 kilograms by vaginal route.

Category: Case Reports
Keywords: Heterotopic Pregnancy. Pregnancy.

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