Spontaneous Heterotrophic Pregnancy with Tubal Rupture and Delivery of a Live Baby at Term: a Case Report

Abstract

Heterotopic pregnancy is the coexistence of intrauterine and extrauterine gestations. It is associated with significant maternal morbidity and
mortality particularly in low resource settings. Spontaneous heterotopic pregnancy is very rarely seen with documented incidence of 1 in 30,000 pregnancies. We present the first case of heterotopic pregnancy
managed in our center with the delivery a live female baby at term.
The case of a 25 year nulliparous lady who presented in our center with lower abdominal pains, amenorrhoea and an ultrasound report confirming an intrauterine pregnancy is presented. Examination revealed mild right iliac fossa tenderness, cervical motion tenderness and a bulky uterus. A trans-vaginal ultrasound scan confirmed a right fimbrial ectopic gestation. A right salpingectomy was performed. The patient subsequently had an uneventful antenatal period and spontaneous vaginal delivery of a live female baby at term. We also review literatures on heterotopic
pregnancy and its management. Spontaneous heterotopic pregnancy, a
potentially fatal condition though rare can occur in our environment. Clinicians should maintain a high index of suspicion in all patients presenting with amenorrhoea and abdominal pains even if an intrauterine pregnancy has been confirmed and a thorough evaluation of the
adnexae using a trans-vaginal ultrasound scan should be routinely performed in such cases.

Keywords: Spontaneous heterotopic pregnancy, live baby, Uyo