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Advanced abdominal pregnancy in a spontaneous heterotopic pregnancy
  1. Nuno Maciel1,
  2. Ana Furtado Lima1,
  3. Rosa Cruz2,
  4. Carlos Ponte1
  1. 1Department of Obstetrics and Gynecology, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
  2. 2Department of Radiology, Hospital do Divino Espirito Santo, Ponta Delgada, Portugal
  1. Correspondence to Dr Nuno Maciel, nunomaciel{at}


Spontaneous heterotopic pregnancy is a potentially life-threatening condition rarely considered when a patient with an intrauterine pregnancy is asymptomatic or presents with complaints such as abdominal pain. An advanced abdominal pregnancy as the form of the ectopic component, outside the context of assisted reproduction, is an even more unusual and perilous diagnosis with very few cases reported in the literature. We report such a case in a 34-year-old multipara, with no known risk factors for ectopic pregnancy. The pregnancy was initially misdiagnosed and managed as a dichorionic gestation, complicated with fetal demise of one of the twins. The correct diagnosis was only made after term delivery of the intrauterine pregnancy. The abdominal pregnancy was subsequently managed via laparotomy with no complications.

  • pregnancy
  • reproductive medicine
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  • Contributors We state that all authors had significant contribution to this paper and agree with all that is written in it. NM: planning, reporting, conception and design, acquisition and interpretation of data. AFL: planning, conduct, conception and design, acquisition and interpretation of data and reviewing. RC: acquisition and interpretation of data. CP: conduct.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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