HETEROTOPIC PREGNANCY – CASE REPORT

OBJECTIVE: Heterotopic pregnancy is the simultaneous occurrence of intrauterine and ectopic pregnancy. This situation is very rare (1:30 000 pregnancies), while recently, with the development of assisted reproductive techniques, the incidence has increased to 1:100 - 1:500 pregnancies. The aim of the study is to present the situation of coexistence of intrauterine pregnancy and ruptured tubal pregnancy. PATIENTS AND METHODS: The case concerns a 32-year-old patient in the 12th week of the second pregnancy in whom the only risk factor was the state after Caesarean section and thus possible intraperitoneal adhesions. The ultrasound revealed normal intrauterine pregnancy and a very large amount of free fluid in the smaller pelvis. After immediate surgical intervention, a ruptured right tubal pregnancy was found. Right fallopian tube was removed. After the operation, the patient with the preserved intrauterine pregnancy was discharged from the ward. Further intrauterine pregnancy was normal. Delivery by Caesarean section. CONCLUSION: Conclusions: The described case indicates that the existence of intrauterine pregnancy does not exclude the existence of ectopic pregnancy and emphasizes the great importance of correctly and accurately carried out ultrasound examination in the first trimester of pregnancy along with appendicitis assessment. Early diagnosis of heterotopic pregnancy reduces the risk of complications.