Laparoscopic Management of a Ruptured Tubal Heterotopic Pregnancy After Spontaneous Conception
DOI:
https://doi.org/10.65495/eurjimr.2026.16Keywords:
Heterotopic pregnancy, Spontaneous conception, Laparoscopy, Ruptured ectopic pregnancy, Intrauterine pregnancyAbstract
Background: Heterotopic pregnancy is a potentially life-threatening clinical condition that poses significant diagnostic challenges, particularly in spontaneous conceptions, due to its rarity and the masking effect of a concurrent intrauterine pregnancy. This case report aims to present the successful laparoscopic management of a ruptured tubal heterotopic pregnancy following spontaneous conception, with preservation of the intrauterine pregnancy.
Case Presentation: We report a 27-year-old woman, gravida 2 para 1, presenting at 7 weeks of spontaneous gestation with lower abdominal pain. Initial ultrasonography confirmed a viable intrauterine pregnancy without free fluid in the pelvis or abdominal cavity. Rapid clinical deterioration with hemoglobin drop prompted further evaluation, and MRI revealed a coexisting ectopic gestational focus. Emergency laparoscopic salpingectomy was performed, removing a ruptured left ampullary ectopic pregnancy. The intrauterine pregnancy was preserved, and postoperative recovery was uneventful.
Conclusions: This case highlights the importance of maintaining a high index of suspicion for heterotopic pregnancy in spontaneous conceptions, the potential utility of advanced imaging when ultrasonography is inconclusive, and the feasibility of laparoscopic management for maternal stabilization while preserving intrauterine pregnancy. Early diagnosis and timely surgical intervention are critical for favorable maternal and fetal outcomes.
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Copyright (c) 2026 Seniye Burcu Torumtay Alıç, Tuğçe Doğan (Author)
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