Heterotopic pregnancy Vital intrauterine pregnancy 12+4, vital ectopic pregnancy 11+4

Objective: We present a case of a 32-year-old female patient, tertigravid after spontaneous conception with acute pain in the abdomen. It was a heterotopic pregnancy at 12 weeks of gestation, with late manifestation of clinical symptoms. Design: Case report. Setting: Department of Obstetrics and Gynecology, Silesian Hospital in Opava. Conclusion: Heterotopic pregnancy is a rare, but potentially fatal complication of early pregnancy. The aim should be to remove the ectopic pregnancy while maintaining the vital intrauterine pregnancy. 76% of pregnancies in utero at the time of intervention for heterotopic pregnancy end in childbirth.