Ruptured heterotopic pregnancy: a report of unusual acute abdominal syndrome in two cases

A heterotopic pregnancy is in effect a multiple pregnancy with one or more intrauterine pregnancies coexisting with an ectopic pregnancy. Prompt diagnosis, rapid fluid and blood resuscitation, heart-sparing anesthesia and gentle, expeditious surgery collectively contribute to a favorable outcome for the mother and fetus in patients with a ruptured tubal pregnancy. In this report we present two cases of heterotopic pregnancies with ruptured tubal components; one spontaneous and the other one after clomiphene citrate treatment. Explorative laparotomy and salpingectomy were performed in both patients. After surgery, the intrauterine pregnancies were not damaged, and were still healthy on progression.