{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:18:41Z","timestamp":1790702321219,"version":"4.1.0"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,7,28]]},"abstract":"<jats:p>Heterotopic pregnancy is a simultaneous intrauterine and ectopic pregnancy. We report a case of a spontaneous ovarian heterotopic pregnancy. A 36-year-old woman, gravida 7 para 4-1-1-5 at 4 weeks gestation (spontaneous conception), presented to the emergency department with vaginal spotting, lower abdominal cramps with human chorionic gonadotropin(hCG) 10 772 mIU\/mL (hCG at T0). Abdominal and pelvic examinations were benign. Transvaginal sonogram (TVS) showed an intrauterine gestational sac and yolk sac, no fetal pole visualised. She was discharged home with a diagnosis of threatened abortion. The patient returned to the emergency department 3 weeks later (T1) at 7 weeks gestation with recurrent vaginal bleeding and lower abdominal pain. Her TVS showed an empty uterus with small amount of free fluid in the cul-de-sac. A small 2\u2009cm round mass noted in the adnexa with hCG of 4663 mIU\/mL (hCG at T1). Laparoscopy revealed normal fallopian tubes bilaterally and a ruptured right ovarian ectopic pregnancy. Pathology was consistent with ectopic pregnancy. Abnormal hCG patterns should raise suspicion for heterotopic pregnancy.<\/jats:p>","DOI":"10.1136\/bcr-2018-225619","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T14:07:31Z","timestamp":1533823651000},"page":"bcr-2018-225619","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Spontaneous ovarian heterotopic pregnancy"],"prefix":"10.1136","volume":"2018","author":[{"given":"Russell","family":"Stanley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjana","family":"Nair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Fiallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,8,9]]},"reference":[{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2006.06.037"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.2","first-page":"565","article-title":"Tale of 2 pregnancies","volume":"62","author":"Chan","year":"2016","journal-title":"Canadian Family Physician"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.3","doi-asserted-by":"publisher","DOI":"10.1186\/1757-1626-2-9369"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.4","first-page":"9","article-title":"Advanced heterotopic pregnancy: a case report","volume":"5","author":"Mohamed","year":"2017","journal-title":"J Gynaecol Obstet"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.5","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.jmig.2015.11.013","article-title":"Heterotopic pregnancy after in vitro fertilization and embryo transfer after bilateral total salpingectomy\/tubal ligation: case report and literature review","volume":"23","author":"Xu","year":"2016","journal-title":"J Minim Invasive Gynecol"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.6","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2010.522749"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.7","first-page":"1","article-title":"Spontaneous heterotopic pregnancy: a case report","volume":"5","author":"Russman","year":"2015","journal-title":"Gynecology and Obstetrics"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2014.08.031"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(99)00079-2"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.10","first-page":"81","article-title":"Spontaneous heterotopic pregnancy leading to intrauterine abortion and subsequent ruptured ectopic pregnancy with a betahCG of 125 mlu\/ml: a case report","volume":"35","author":"Trompoukis","year":"2008","journal-title":"Clin Exp Obstet Gynecol"},{"key":"2025042705503634000_2018.aug09_2.bcr-2018-225619.11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/509694","article-title":"Spontaneous heterotopic pregnancy, simultaneous ovarian, and intrauterine: a case report","volume":"2012","author":"Basile","year":"2012","journal-title":"Case Rep Obstet Gynecol"}],"updated-by":[{"DOI":"10.1136\/bcr-2018-225619corr1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2018,9,1]],"date-time":"2018-09-01T00:00:00Z","timestamp":1535760000000}}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225619","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T12:50:44Z","timestamp":1745758244000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225619"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,9]]},"references-count":11,"alternative-id":["10.1136\/bcr-2018-225619"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225619","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,9]]}}}