Heterotopic pregnancy which corse with tubal ectopic and intrauterine triplet pregnancy

Heterotopic pregnancies, simultaneous precence of intrauterine and extrauterine pregnancies is rare condition. Heterotopic pregnancies incidance is increasing with the use of asisted reproductive technology and ovulation induction methods. The early diagnosis of the heterotopic pregnancies is very important for maternal-fetal mortality and morbidity. An 8 week multipl pregnant women with clomiphene citrate ovulation induction, admitted to our hospital with complaints of acute abdomen and vaginal bleeding. Transvaginal USG revealed intraabdominal wide free fluid, intrauterine triplet pregnancy, and fetal cardiac activity positive, living fetus in left fallopian tube. Explaratory laparotomy was made for the cause of acute abdomen. Laparatomy revealed 2000 cc blood, and unruptured left tubal ectopic pregnancy. Left salpengectomy was done. After discharge patient was controlled with follow up visits. As a result if first trimester pregnancies of asisted reproductive technologies and ovulation induction, with complaint of abdominal pain and vaginal bleeding, heterotropic pregnancies also be discarded