title: A case of heterotopic pregnancy in the absence of risk factors. A brief literature review.
abstract: OBJECTIVE
  To reinforce the risk of heterotopic pregnancy in a natural cycle when intrauterine pregnancy and abdominal pain co-exist.
  
  
  METHODS
  A single case report with a literature review.
  
  
  RESULTS
  Our case was associated with significant haemorrhage, laparotomy and salpingectomy. The obstetric outcome was favourable in this case. The literature review demonstrates the diagnostic difficulties as well as treatment options.
  
  
  CONCLUSIONS
  Sonographic diagnosis of a heterotopic pregnancy is not always possible. Patients with abdominal pain and intrauterine pregnancy should heighten the clinician's suspicion of a heterotopic pregnancy.
authors.affiliation: First Department of Obstetrics and Gynaecology, Alexandra Maternity Hospital, Athens University, Athens, Greece. loufty28@yahoo.gr
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Anastasakis
authors.forename: Anand
authors.initials: A
authors.lastname: Jetti
authors.forename: Lena
authors.initials: L
authors.lastname: Macara
authors.forename: George
authors.initials: G
authors.lastname: Daskalakis
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D000290:Adnexa Uteri / Q000000981:diagnostic imaging*; D000328:Adult; D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D050498:Live Birth; D011247:Pregnancy; D018607:Pregnancy Reduction, Multifetal; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D012307:Risk Factors; D012422:Rupture, Spontaneous / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D016216:Ultrasonography, Prenatal