Heterotopic pregnancy presenting with intra-abdominal haemorrhage and shock

Heterotopic pregnancy is a rare pregnancy complication in which a viable intrauterine pregnancy coincides with an ectopic pregnancy. Presentations vary widely and present a diagnostic challenge in the emergency setting. With the advent of assisted reproductive technologies, its incidence is increasing and a normal pregnancy in the setting of abdominal pain without definitive radiographic evidence for cause can complicate the diagnosis, leading to a delay in care which could increase morbidity. We present a case of a patient with a 7-week, 1-day gestation pregnancy and haemorrhagic shock with sonographic complex fluid in the abdomen who was treated with emergent laparoscopy with intraoperative findings of ruptured ectopic pregnancy.