Abstract

A heterotopic pregnancy is a rare condition in which at least two simultaneous gestations occur at two different implantation sites. A high rate of suspicion can be crucial in timely diagnosis and appropriate interventions. We report the very rare case of a nulliparous woman presented to the emergency department with hemoperitoneum from a ruptured tubal pregnancy in a spontaneous conception after self-uncontrolled ovulation induction resulting in a quadruplet heterotopic pregnancy: A triplet intrauterine pregnancy and a single left tubal ectopic pregnancy. An heterotopic pregnancy is an obstetric complication of difficult clinically diagnose and in most cases, surgically confirmed. This early approach is indispensable especially when there are hemodynamic repercussions. The factors related to the higher risk of developing heterotopic pregnancy coincide with those associated with ectopic pregnancy. In this case the hyperovulation caused by uncontrolled ovulation inducers was the most likely factor in the genesis of this condition.

Keywords: Heterotopic pregnancy; Ectopic pregnancy; Ovulation induction