Uterine Rupture with Cesarean Scar Heterotopic Pregnancy with Survival of the Intrauterine Twin.

. Heterotopic pregnancy is a multiple gestation with both intrauterine and ectopic fetuses. A cesarean scar ectopic pregnancy is when the fetus has implanted over the previous hysterotomy site. A known complication of cesarean scar ectopic pregnancy is uterine rupture, which can cause great morbidity and mortality. . 28-year-old G5P3105 at 10 weeks with a dichorionic diamniotic gestation was found to have a ruptured uterus with expulsion of a cesarean scar ectopic pregnancy and retention of the intrauterine fetus. After uterine repair, the singleton gestation reached viability was delivered by emergent cesarean section for placental abruption. . Safe management of cesarean ectopic pregnancy requires early diagnosis by ultrasonography. With early detection, management can focus on preventing maternal morbidity of uterine rupture and life-threatening hemorrhage.