Management of a heterotopic pregnancy presenting with haemorrhagic shock and massive haemoperitoneum

ABSTRACT

The incidence of heterotopic pregnancy is on the rise, from 1 in 30000 pregnancies, to as high as 1 in 3800 today. We report here a case of a 31-year-old Asian lady who presented with sudden onset of acute abdominal pain and massive haemoperitoneum. An ultrasound scan confirmed a viable 10 weeks intrauterine pregnancy, with massive free fluid in the abdomen warranting surgery. A provisional diagnosis of a ruptured corpus luteal cyst/ ruptured ectopic/ heterotopic pregnancy was made. Laparoscopy revealed a bleeding ectopic pregnancy in the isthmus region of the right tube, which was treated by linear salpingotomy. Skilled surgical expertise in dealing with the massive haemoperitoneum enabled us to accomplish the surgery with minimal trauma to the continuing intrauterine pregnancy