Flmban Merfat M, Mohammed Reem H, Alshehri Hanan M, Aljuhani Suhad A, Baamer Rahaf F, Alsahafi Nouf A, Aljedani Alaa M
Obstetrics and Gynecology, Al Thagher General Hospital, Jeddah, SAU.
General Surgery, Al Thagher General Hospital, Jeddah, SAU.
Cureus. 2025 Jan 6;17(1):e77020. doi: 10.7759/cureus.77020. eCollection 2025 Jan.
Heterotopic pregnancy is defined as the concurrent presence of both an intrauterine pregnancy and an extrauterine (typically ectopic) pregnancy. This report presents the case of a 36-year-old female patient who presented to the emergency department with lower abdominal pain. A comprehensive evaluation, including transabdominal and transvaginal ultrasound imaging, revealed a heterotopic pregnancy at an estimated gestational age of six weeks and two days. The ultrasound examination confirmed an intrauterine pregnancy with fetal cardiac activity and a visible fetal pole, as well as a complex vascular lesion in the left adnexal region. Consequently, the patient underwent exploratory laparotomy, including a left salpingectomy, to remove the ruptured left tubal ectopic pregnancy. The ectopic pregnancy was successfully excised, and the intrauterine embryo was preserved. Following this surgical intervention, the pregnancy progressed without complications, culminating in the delivery of a healthy infant at 39 weeks of gestation. With timely and appropriate treatment, a heterotopic pregnancy can result in a successful live birth, yielding favorable outcomes for both mother and child. This case underscores the necessity of considering heterotopic pregnancy even in the absence of risk factors and highlights the importance of multidisciplinary management to achieve optimal outcomes.
异位妊娠定义为子宫内妊娠和子宫外（通常为异位）妊娠同时存在。本报告介绍了一名36岁女性患者的病例，该患者因下腹部疼痛前往急诊科就诊。包括经腹和经阴道超声成像在内的全面评估显示，估计孕周为六周零两天时存在异位妊娠。超声检查证实子宫内妊娠有胎心活动和可见的胎芽，以及左侧附件区的复杂血管病变。因此，患者接受了包括左侧输卵管切除术在内的剖腹探查术，以切除破裂的左侧输卵管异位妊娠。异位妊娠成功切除，子宫内胚胎得以保留。此次手术干预后，妊娠进展顺利，无并发症，最终在妊娠第39周分娩出一名健康婴儿。通过及时、恰当的治疗，异位妊娠可成功实现活产，为母婴带来良好结局。该病例强调，即使没有危险因素，也有必要考虑异位妊娠，并突出了多学科管理对实现最佳结局的重要性。
