title: Heterotopic pregnancy after in vitro fertilization and embryo transfer: a case report.
abstract: BACKGROUND
  Heterotopic pregnancy is a life-threatening complication of pregnancy defined as coexistent intrauterine and ectopic gestation. Its diagnosis is frequently overlooked and delayed.
  
  
  METHODS
  A 28-year-old woman experienced acute abdominal pain in pregnancy achieved by in vitro fertilization. Since all previous checkups indicated a normal course of pregnancy, the ectopic pregnancy was not suspected on admission. However, due to persistent hypotension, this diagnosis was also considered.Transvaginal ultrasound performed by an experienced obstetrician revealed an adnexal mass highly indicative of ectopic pregnancy. No fetal heart beats were visualized and the diagnosis of a missed abortion was made. A prompt laparotomy revealed a ruptured right ampullary pregnancy, and salpingectomy was performed.
  
  
  CONCLUSIONS
  Although rare, heterotopic pregnancy should be considered in the differential diagnosis of abdominal pain in pregnancy. Every physician treating women of reproductive age should bear in mind the possibility of heterotopic pregnancy not only in patients with predisposing risk factors but also in those without them.
authors.affiliation: Institute of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia. radmila@rcub.bg.ac.rs
authors.forename: Radmila
authors.initials: R
authors.lastname: Sparić
authors.forename: Snezana
authors.initials: S
authors.lastname: Buzadzić
authors.forename: Rajka
authors.initials: R
authors.lastname: Argirović
authors.forename: Danijela
authors.initials: D
authors.lastname: Bratić
authors.forename: Darko
authors.initials: D
authors.lastname: Plećas
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D004624:Embryo Transfer / Q000009:adverse effects*; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D011247:Pregnancy; D063192:Pregnancy, Heterotopic / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery