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A heterotopic pregnancy is a rare complication of pregnancy in which both extra Uterine (ectopic pregnancy) and intra uterine pregnancy occur simultaneously. It may also be referred to as a combined ectopic pregnancy, multiple sited pregnancy or coincident pregnancy. The estimated  incidence for a naturally conceived pregnancy is 130000. The incidence among patients with assisted reproduction is higher and is thought to be around 1-3100. Due to this assisted  reproduction, the overall incidence has increased over the years. We report a case of heterotopic pregnancy in a 25 year old woman presented with hemoperitoneum from ruptured tubal pregnancy with failed intra uterine gestation at 9 weeks of amenorrhoea, diagnosed on ultrasound examination and treated by emergency laparotomy.


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