title: Ruptured tubal pregnancy associated with intrauterine pregnancy complicated by fetal holoprosencephaly: a case report.
abstract: BACKGROUND
  Naturally occurring heterotopic pregnancy is rare. A surviving intrauterine pregnancy associated with a ruptured tubal pregnancy is extremely unusual.
  
  
  METHODS
  This is the first reported case of a patient presenting in hemorrhagic shock due to a ruptured tubal pregnancy that was associated with an ongoing intrauterine pregnancy complicated by fetal holoprosencephaly.
  
  
  CONCLUSIONS
  Delays in diagnosis and treatment of heterotopic pregnancies may adversely affect maternal health as well as the outcome of the intrauterine pregnancy. Prenatal screening and/or diagnostic studies are necessary to evaluate the intrauterine pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, West Virginia University School of Medicine-Charleston Division and Charleston Area Medical Center, USA.
authors.forename: Dara P
authors.initials: DP
authors.lastname: Aliff
authors.forename: Christos G
authors.initials: CG
authors.lastname: Hatjis
authors.forename: S Greg
authors.initials: SG
authors.lastname: Heywood
authors.forename: Randall J
authors.initials: RJ
authors.lastname: Hill
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D016142:Holoprosencephaly / Q000150:complications / Q000175:diagnosis* / Q000196:embryology; D006801:Humans; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000473:pathology; D011296:Prenatal Diagnosis; D012421:Rupture; D012771:Shock, Hemorrhagic / Q000209:etiology*