Heterotopic pregnancy (HP) is a condition where there are two pregnancies in different places- a eutopic and ectopic pregnancy. Spontaneous HP are rare and happen in less than 1:30,000 pregnancies1. The incidence can increase with assisted reproductive techniques, previous tubal and pelvic surgery, previous ectopic pregnancy, and pelvic infections.

Patients might present with abdominal pain or vaginal bleeding; however, some may be asymptomatic. 7 in 10 heterotopic pregnancies are diagnosed before 8 weeks of pregnancy2. Transvaginal ultrasound scanning plays an essential role in early diagnosis and management of HP.