{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T16:44:02Z","timestamp":1726505042975},"reference-count":9,"publisher":"California Digital Library (CDL)","issue":"2","license":[{"start":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T00:00:00Z","timestamp":1587600000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Heterotopic pregnancies are rare. However, they are occurring with increasing frequency. Unfortunately, diagnosis is frequently delayed, with patients presenting in extremis.\n\nCase Report: We present a case of a heterotopic pregnancy diagnosed by point-of-care ultrasound (POCUS) in a woman presenting with lower abdominal pain, who had a documented normal first trimester ultrasound the day prior to presentation.\n\nDiscussion: Given the increasing rates of heterotopic pregnancies, we can no longer be reassured by the presence of an intra-uterine pregnancy (IUP) in a patient with concerning signs and symptoms of a ruptured ectopic pregnancy. A thorough POCUS evaluation of the uterus and adnexa is essential for the diagnosis of heterotopic pregnancy in the emergency department.\n\nConclusion: This case highlights the value POCUS brings to the emergency department evaluation of patients in early pregnancy.<\/jats:p>","DOI":"10.5811\/cpcem.2020.2.45933","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T22:21:32Z","timestamp":1588717292000},"page":"178-180","source":"Crossref","is-referenced-by-count":3,"title":["Heterotopic Pregnancy Diagnosed with Point-of-care Ultrasound in the Emergency Department: A Case Report"],"prefix":"10.5811","volume":"4","author":[{"given":"Ian","family":"Holley","sequence":"first","affiliation":[{"name":"Washington University School of Medicine in St. Louis, Department of Emergency Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean","family":"Stickles","sequence":"additional","affiliation":[{"name":"Washington University School of Medicine in St. Louis, Department of Emergency Medicine, St. Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2020,4,23]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"DeVoe RW and  Pratt J. Simultaneous intrauterine and extrauterine pregnancy.\u00a0Am J Obstet  Gynecol 1948;56(6):1119-26.","DOI":"10.1016\/S0002-9378(48)90357-3"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Kwok TC and Morgan G. Think Heterotopic: A Case Report of Heterotopic Pregnancy Detected on Thorough Ultrasonography.\u00a0J Medical Cases. 2012;3(5):326-8.","DOI":"10.4021\/jmc779w"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Breyer MJ and Costantino TG. Heterotopic gestation: another possibility for the emergency bedside ultrasonographer to consider.\u00a0J Emerg Med. 2004;26(1):81-4.","DOI":"10.1016\/j.jemermed.2003.06.004"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Avitabile NC, Kaban NL, Siadecki SD, et al. Two cases of heterotopic pregnancy: review of the literature and sonographic diagnosis in the emergency department.\u00a0J Ultrasound Med. 2015;34(3):527-30.","DOI":"10.7863\/ultra.34.3.527"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Press GM and Martinez A. Heterotopic pregnancy diagnosed by emergency ultrasound.\u00a0J Emerg Med. 2007;33(1):25-7.","DOI":"10.1016\/j.jemermed.2007.01.002"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Mihmanli V, Kilickaya A, Cetinkaya N, et al. Spontaneous Heterotopic Pregnancy Presenting\u00a0with Hemoperitoneum.\u00a0J Emerg Med. 2016;50(1):44-6.","DOI":"10.1016\/j.jemermed.2015.02.050"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Crochet JR, Bastian LA, Chireau MV. Does this woman have an ectopic pregnancy? the rational clinical examination systematic review.\u00a0JAMA. 2013;309(16):1722-9.","DOI":"10.1001\/jama.2013.3914"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Wang PS, Rodgers SK, Horrow MM. Ultrasound of the First Trimester.\u00a0Radiol Clin North Am. 2019;57(3):617-33.","DOI":"10.1016\/j.rcl.2019.01.006"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Louis-Sylvestre C, Morice P, Chapron C, et al. The role of laparoscopy in the diagnosis and management of heterotopic pregnancies.\u00a0Hum Reprod. 1997;12(5):1100-2.","DOI":"10.1093\/humrep\/12.5.1100"}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T20:38:52Z","timestamp":1595277532000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/4612b75k"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,23]]},"references-count":9,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020,4,1]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2020.2.45933","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"type":"electronic","value":"2474-252X"},{"type":"print","value":"2474-252X"}],"subject":[],"published":{"date-parts":[[2020,4,23]]}}}