Conclusions
Heterotopic pregnancy is a very rare condition that requires a high
index of clinical suspicion that may occasionally face health care
professionals in obstetrics, gynecology and emergency departments. It is
even less common after a spontaneous conception. Although a high index
of suspicion for ectopic pregnancy is part and parcel of the clinical
practice, yet the guard can at times lower when seeing an intrauterine
pregnancy with many cases of heterotopic pregnancy misdiagnosed and a
good number only discovered at later stages after rupture of the ectopic
arm of heterotopic pregnancy. We believe that cases like this one can
play a small part to help keep that vigilance. Ultrasound remains the
imaging modality of choice in diagnosing a heterotopic pregnancy,
however, in carefully selected cases, an MRI with a reported safety in
the first trimester can be utilized and may provide added information
over ultrasound. Salpingectomy rather than salpingotomy via laparoscopy
should be the treatment of choice in most heterotopic pregnancies with
the extrauterine pregnancy in the tube.