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Heterotopic Pregnancy Diagnosed with Point-of-care Ultrasound in the Emergency Department: A Case Report

  • Author(s): Holley, Ian J.
  • Stickles, Sean P.
  • et al.

Introduction: Heterotopic pregnancies are rare. However, they are occurring with increasing frequency. Unfortunately, diagnosis is frequently delayed, with patients presenting in extremis.

Case Report: We present a case of a heterotopic pregnancy diagnosed by point-of-care ultrasound (POCUS) in a woman presenting with lower abdominal pain, who had a documented normal first trimester ultrasound the day prior to presentation.

Discussion: Given the increasing rates of heterotopic pregnancies, we can no longer be reassured by the presence of an intra-uterine pregnancy (IUP) in a patient with concerning signs and symptoms of a ruptured ectopic pregnancy. A thorough POCUS evaluation of the uterus and adnexa is essential for the diagnosis of heterotopic pregnancy in the emergency department.

Conclusion: This case highlights the value POCUS brings to the emergency department evaluation of patients in early pregnancy.

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