Unusual presentation of heterotopic pregnancy: a case report.

The incidence of heterotopic pregnancy has been rising in recent years with the increased use of assisted reproductive techniques (ART). This report describes an unusual clinical presentation in a 24-year-old woman who had a combination of intrauterine triplets and a single intrafallopian pregnancy. Two fetuses located on the same side as the ectopic pregnancy demised after rupture of an ectopic pregnancy at seven weeks of gestation. After performing emergency exploratory laparotomy to manage the ruptured ectopic pregnancy, one intrauterine pregnancy continued smoothly, resulting in the delivery of a 3,550 g normal baby at 38 weeks of gestation. The possible cause of fetal demise may have been the ruptured ectopic pregnancy of the left tube, which compromised the blood supply to the same side of the gestational sacs, but the sac implanted on the right side was compensated by prominent collateral circulation, although that remains a hypothesis. To our knowledge, this is a novel report of such an occurrence.