{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T01:34:24Z","timestamp":1773797664487,"version":"3.50.1"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>This report describes a 26-year-old female who presented at 5 weeks of gestation with intrauterine pregnancy after gonadotrophin stimulation and intrauterine insemination. The patient complained of abdominal pain, abdominal distension and nausea diagnosed as moderate ovarian hyper-stimulation syndrome (OHSS) with early pregnancy and was treated accordingly. The patient was readmitted at 7 and 9 weeks of gestation with persistent left lower abdominal pain. At 9 weeks\u2019 gestation she also had a low grade fever and since the pelvic ultrasound showed a left tubo-ovarian mass she was treated for pelvic infection. The follow-up ultrasounds in the 5th, 9th and 12th weeks showed a normal intrauterine pregnancy in addition to a persistent left adnexal mass without any suspicion of a heterotopic pregnancy. The diagnosis of heterotopic pregnancy became possible only at 13 weeks of gestation during laparotomy when the right fallopian tube showed a leaking ectopic pregnancy. A right-sided salpingostomy was carried out. The intrauterine pregnancy is still ongoing without complications.<\/jats:p>","DOI":"10.1136\/bcr.08.2008.0779","type":"journal-article","created":{"date-parts":[[2009,2,26]],"date-time":"2009-02-26T21:33:45Z","timestamp":1235684025000},"page":"bcr0820080779","source":"Crossref","is-referenced-by-count":2,"title":["Heterotopic pregnancy: a growing diagnostic challenge"],"prefix":"10.1136","volume":"2009","author":[{"given":"Azza G","family":"Ibrahim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faiza","family":"Badawi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muna","family":"Tahlak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,2,26]]},"reference":[{"key":"2025042507270794000_2009.feb24_1.bcr0820080779.1","doi-asserted-by":"publisher","DOI":"10.4065\/76.1.90"},{"key":"2025042507270794000_2009.feb24_1.bcr0820080779.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(99)00242-3"},{"key":"2025042507270794000_2009.feb24_1.bcr0820080779.3","unstructured":"Heard MJ Buster JE Ectopic pregnancy.In: Scott J R Gibbs R S Karlan B Y , eds. Obstetrics and gynecology. Philadelphia, PA: Lippincott, Williams and Wilkins, 2003: 89\u2013102."},{"key":"2025042507270794000_2009.feb24_1.bcr0820080779.4","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/S0015-0282(16)54258-7","article-title":"The incidence of combined intrauterine and extrauterine pregnancy after in vitro fertilization and embryo transfer","volume":"55","author":"Dor","year":"1991","journal-title":"Fertil Steril"},{"key":"2025042507270794000_2009.feb24_1.bcr0820080779.5","first-page":"463","article-title":"Heterotopic pregnancy after in vitro fertilization and embryo transfer","volume":"77","author":"Ikeda","year":"1998","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025042507270794000_2009.feb24_1.bcr0820080779.6","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/"},{"key":"2025042507270794000_2009.feb24_1.bcr0820080779.7","first-page":"331","article-title":"Ovarian hyperstimulation syndrome and heterotopic pregnancy after IVF","volume":"25","author":"Prapas","year":"1994","journal-title":"Acta Eur Fertil"},{"key":"2025042507270794000_2009.feb24_1.bcr0820080779.8","unstructured":"Harrington JC Lyons EA . Heterotopic pregnancy. See http:\/\/www.thefetus.net\/page.php?id=3 (accessed 17 February 2007)."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.08.2008.0779","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T14:27:12Z","timestamp":1745591232000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.08.2008.0779"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009]]},"references-count":8,"alternative-id":["10.1136\/bcr.08.2008.0779"],"URL":"https:\/\/doi.org\/10.1136\/bcr.08.2008.0779","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009]]}}}