title: Spontaneous heterotopic triplets: a case report.
abstract: OBJECTIVE
  To present a case report of a spontaneous, heterotopic, triplet conception of a patient without any risk factors.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Community hospital in Park Ridge, Illinois.
  
  
  METHODS
  One patient, 30-year-old multigravida, sent to the emergency room for evaluation of right lower quadrant pain after confirmed identification of an early, intrauterine pregnancy by an office ultrasound. The patient was taken to the operating room for suspected appendicitis and found to have a right ruptured ectopic pregnancy with a normal appendix.
  
  
  METHODS
  The patient underwent a laparoscopic right salpingostomy with hydrodissection of the ectopic pregnancy.
  
  
  METHODS
  Follow-up pelvic ultrasounds confirmed a viable, spontaneous twin intrauterine pregnancy.
  
  
  RESULTS
  The twin pregnancy continued without complications until 34 weeks' gestation, when the patient began preterm labor and delivered healthy twins.
  
  
  CONCLUSIONS
  Even in the absence of infertility treatments and/or risk factors, heterotopic pregnancy should be included in the differential diagnosis for lower quadrant abdominal or pelvic pain.
authors.affiliation: Department of Obstetrics and Gynecology, Advocate Lutheran General Hospital, Park Ridge, Illinois 60068, USA. acholkeri@gmail.com
authors.forename: Aarathi
authors.initials: A
authors.lastname: Cholkeri-Singh
authors.forename: Ann
authors.initials: A
authors.lastname: LaBarge
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis; D001064:Appendicitis / Q000175:diagnosis; D003937:Diagnosis, Differential; D005187:Fallopian Tubes; D005260:Female; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis; D014310:Triplets