title: Ruptured heterotopic pregnancy in a natural conception cycle: a case report at the Yaounde central Hospital (Cameroon).
abstract: Heterotopic pregnancy is very rare under natural circumstances. We report the case of a 28 year old Gravida2 Para1001 woman at 9 weeks of pregnancy who consulted in emergency for acute pelvic pain following metrorrhagia. Physical exam revealed hemoperitoneum without shock. An emergency ultrasonography revealed two gestational sacs, one intra-uterine and the other extra-uterine. Laparotomy was done and the findings were: a ruptured right tubal pregnancy with 1,300 milliliters of hemoperitoneum, type B left utero-adnexal adhesions and an increased uterus consistent with a 9 weeks pregnancy. Right total salpingectomy was done and the patient did well postoperatively. That intrauterine pregnancy evolved normally under progesterone supply and the woman delivered a termed live female baby weighing 3.1 kilogrammes. In our context where ultrasound is not always available, practitioners carrying out salpingectomy for ruptured ectopic pregnancies should bear in mind the plausibleness of heterotopic pregnancy in order to properly handle the uterus.
authors.affiliation: Obstetrics and Gynecology Unit of the Yaounde Central Hospital-Cameroon ; Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1- Cameroon.
authors.forename: Jeanne Hortence
authors.initials: JH
authors.lastname: Fouedjio
authors.affiliation: Obstetrics and Gynecology Unit of the Yaounde Central Hospital-Cameroon.
authors.forename: Florent Ymele
authors.initials: FY
authors.lastname: Fouelifack
authors.affiliation: Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1- Cameroon.
authors.forename: Jovanny Tsuala
authors.initials: JT
authors.lastname: Fouogue
authors.affiliation: Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1- Cameroon ; Head of the pathology unit of the Yaounde Gyneco-Obstetric and pediatric hospital - Cameroon.
authors.forename: Zacharie
authors.initials: Z
authors.lastname: Sando
mesh_terms: D000328:Adult; D002163:Cameroon; D005260:Female; D006801:Humans; D007813:Laparotomy; D011247:Pregnancy; D011256:Pregnancy Outcome; D063192:Pregnancy, Heterotopic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012422:Rupture, Spontaneous; D058994:Salpingectomy / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods
keywords: Cameroon; ectopic; hemoperitoneum; heterotopic; pregnancy