ABSTRACT
Heterotopic pregnancy is the simultaneous occurrence of intrauterine and ectopic pregnancies. It is rare in spontaneous pregnancies, occurring only in 1 per 30,000. It is a life-threatening condition with diagnostic and therapeutic difficulties. We report a case of a 16 year old with a previous unsafe abortion with a diagnosis of a ruptured ectopic pregnancy. Meticulous Ultra sound assessment resulted in the diagnosis of Heterotopic pregnancy. She had laparatomy and manual vacuum aspiration. Spontaneous heterotopic pregnancy is a life threatening condition especially in poor resource setting like ours with paucity of diagnostic equipment. Clinicians should have a high index of suspicion for heterotopic pregnancy when evaluating young teenage girls with complaints of abdominal pain and amenorrhea. In addition, tackling the unmet need for contraception in our environment, especially emergency contraception will ameliorate the morbidity and mortality associated with this rare condition.