Laparoscopy of Spontaneous Heterotopic Pregnancy

HKJGOM 2007; 7 (1) 53 Introduction It is commonly thought that the presence of an intra-uterine pregnancy excludes the diagnosis of ectopic pregnancy because heterotopic pregnancy is extremely rare. This may be reasonable with the estimated incidence of heterotopic pregnancy at 1 in 30 000 in the past. However recent studies have noted an increase in incidence to 1 in 4000 to 1 in 8000, with higher numbers in patients who have undergone fertility augmentation. In fact the incidence of heterotopic pregnancy can reach up to 1 in 100 in patients who have assisted reproduction1. Thus heterotopic pregnancy should always be considered in patients presenting with signs and symptoms of miscarriage.