Case 03: Heterotopic Pregnancy Ultrasound

Introduction:

Heterotopic pregnancy means the presence of both intrauterine and extrauterine pregnancy.

Clinical Features:

Reproductive aged female patient came with the history of
1. Amenorrhoea for 2 months followed by per vaginal bleeding with fleshy mass expulsion.
2. Severe lower abdominal pain, more on the left side.

Clinically, the patient was anemic.

Ultrasound Findings:

1. An irregular distorted gestational sac is noted within the uterus with decidual reaction and without any fetal pole.

2. Left tubo-ovarian region shows an irregular small gestational sac, surrounded by an irregular thick wall forming donut sign, without any feta pole inside. Color Doppler shows relatively high resistance pattern of arterial supply (RI: 0.71) around the sac which literally excludes the presence of life inside the sac.

3. Huge pelvic collection is noted.

Images:

Features Highly Suggestive Of:

Heterotopic pregnancy including incomplete abortion for the intrauterine one and ruptured ectopic for the extrauterine one.

Scanning was done on the 17.05.18 at 2-3am.