Heterotopic pregnancy is a potentially life threatining condition and an important cause of mortality and morbidity. Risk of heterotopic pregnancy is increased by assisted reproductive techniques (ART). We report such a case of heterotopic pregnancy after embryo transfer in a primary infertile 38 year old woman. Sixteen days after detection of intrauterine pregnancy by ultrasound, the patient admitted to emergency service with severe abdominal pain. She underwent surgery and her preoperative diagnosis was undetermined intraperitoneal bleeding. Ruptured heterotopic pregnancy diagnosed after diagnostic laparotomy and salpingectomy performed at the same procedure. Her postoperative status and the course of pregnancy unremarkable. A healthy baby was delivered at 38 week of gestation without any further complication. Heterotopic pregnancy is an important cause of acute abdomen after embryo transfer. Although it’s diagnosis and management is challenging, with proper diagnosis and treatment, potential risks can be minimized and concomitant intrauterine pregnancy can be preserved.

Keywords: Heterotopic pregnancy, acute abdomen, ectopic pregnancy