Objective: To reinforce the risk of heterotopic pregnancy in a natural cycle when intrauterine pregnancy and abdominal pain co-exist. Method: A single case report with a literature review. Results: Our case was associated with significant haemorrhage, laparotomy and salpingectomy. The obstetric outcome was favourable in this case. The literature review demonstrates the diagnostic difficulties as well as treatment options. Conclusions: Sonographic diagnosis of a heterotopic pregnancy is not always possible. Patients with abdominal pain and intrauterine pregnancy should heighten the clinician’s suspicion of a heterotopic pregnancy.

Poster abstracts reaction. A hemorrhagic endometrial mass of 4 × 3 × 2.5 cm is noted in the lower uterine segment. There is implantation by intermediate trophoblast (extravillous cytotrophoblast) amidst myometrial smooth muscle as well as intramurally and intimally within ectatic maternal vessels. Conclusion: Uterine AVM may be associated with subsequent undesirable outcome in pregnancy.

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