Missed Diagnosis of a Heterotopic Pregnancy with Tubal Rupture: A Case Report
We report a combined intra-uterine and ruptured tubal pregnancy following ovulation induction by clomiphene citrate(CC).She was a 35 year old multigravida who presented with a ruptured tubal pregnancy and underwent right salphingectomy. Three months later, she presented with amenorrhea from the time of operation and an intra-uterine pregnancy was confirmed. Previous ultrasound at her initial presentation, did not reveal an intra-uterine pregnancy. The second ultrasound dating indicated that the intra-uterine conception had occurred before the tubal pregnancy was diagnosed. Therefore, a high index of suspicion for heterotopic pregnancy is needed in woman taking ovulation inducing drugs.
KeywordsClomiphene citrate; heterotopic pregnancy; ruptured tubal pregnancy
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