Ruptured heterotopic pregnancy with successful obstetrical outcome: a case report and review of the literature

Emergency medicine has encountered in the last decades a gradual increase in cases of heterotopic pregnancy (HP) with rupture of the ectopic part. The rise of this entity is mainly due to ovulation induction performed in women undergoing assisted reproductive techniques (ART), but in natural cycles is still rare and unexpected. Diagnosis is often delayed especially in cases where no predisposing factors exist, causing life threatening situations. We report a case of a ruptured heterotopic pregnancy presenting at seven weeks of gestation that was treated with immediate laparotomy. The rest of the pregnancy course was uneventful with spontaneous vaginal delivery of a healthy infant at 39 weeks of gestation. A review of the diagnosis and management of heterotopic pregnancy is also given.