Heterotopic Pregnancy in Natural Conception: A Rare Clinical Entity

Spontaneous heterotopic pregnancy is a rare condition in a natural cycle without any risk factors and it is difficult to assess as pain and bleeding might be attributed to threatened abortion also. We are reporting a case of spontaneous heterotopic pregnancy in a natural cycle which was missed in the initial transvaginal scan and was reported to be an intrauterine pregnancy which later presented with clinical features of ruptured ectopic pregnancy. So, if assisted reproduction technique (ART) is not involved, the index of suspicion of a heterotopic pregnancy is usually very low and can cause more serious complications as diagnosis may be delayed.