Abstract
Heterotopic pregnancy is an extremely rare complication with an estimated incidence of < 1/30,000 (< 0.003%) in spontaneous conceptions [1]. The incidence, however, increases to 0.2-1.0% with use of assisted reproduction techniques and presence of tubal pathologies. The diagnosis of heterotopic gestation is difficult in early gestation due to lack of significant clinical symptoms. A heterotopic gestation may go unnoticed in the presence of intrauterine pregnancy. We present a case of spontaneous heterotopic gestation in a primigravida, highlighting the diagnostic role of serial transvaginal ultrasound assessments in the absence of significant clinical signs and symptoms. The patient was treated with laparoscopic salpingectomy, with further uneventful continuation of intrauterine gestation.