A Rare Case of Heterotopic Pregnancy in a Unicornuate Uterus

Heterotopic pregnancy, a condition involving simultaneous intrauterine and extrauterine pregnancies, is a rare clinical scenario, particularly when associated with a unicornuate uterus. This rarity underscores the importance of recognising and managing such cases promptly. A 24-year-old primigravida presented at 10 weeks of gestation with per vaginal spotting and abdominal pain, along with a history of ovulation induction. Pelvic ultrasound showed a heterotopic pregnancy in a unicornuate uterus, with a possible pseudo-gestational sac and a left ruptured tubal ectopic pregnancy. The combination of a ruptured ectopic pregnancy and an intrauterine pregnancy highlights the importance of early detection and surgical management. This case emphasises the rarity of heterotopic pregnancy in a unicornuate uterus. A unicornuate uterus with rudimentary horns results from incomplete Müllerian duct fusion and carries significant risks, including rupture during pregnancy. Early diagnosis and surgical intervention are essential to prevent life-threatening complications, with treatment options varying based on the patient’s condition and gestational age.