Diagnosing Emergent Heterotopic Pregnancy via Point-of-Care Ultrasound: A Case Report

Patients undergoing assisted reproductive treatments are at a much higher risk for developing heterotopic pregnancy, a rare complication marked by concurrent intrauterine and ectopic pregnancies. Ruptured ectopic pregnancies are one of the leading causes of pregnancy-related mortality. We report the case of a 31-year-old woman undergoing ovulation induction that presented to the emergency department (ED) with worsening abdominal pain. Point-of-care ultrasound (POCUS) performed in the ED identified a heterotopic pregnancy in which the ectopic gestational sac had ruptured. The patient was immediately taken to the operating room for surgical management without obtaining a formal radiology-performed ultrasound. Nonspecific abdominal pain is one of the most common complaints for patients presenting to the ED. The usage of POCUS allows for rapid visualization of the abdominal cavity to diagnose the underlying cause of a patient’s abdominal pain. This case demonstrates that complex etiologies can be reliably visualized and diagnosed without needing to wait for a formal radiology study.