Heterotopic Pregnancy, It is Such a Rare Finding?

Heterotopic pregnancy is a multiple pregnancy with simultaneous implantation of the embryos at two or more distinct locations. Risk factors, epidemiology, signs, symptoms, sonographic findings and management options are reviewed. Literature data indicates an increase of the prevalence of heterotopic pregnancy and a trend increase toward sonographic diagnosis at an earlier stage, before rupture. In order to facilitate early diagnosis, the dictum “think heterotopic” is never overemphasized also in the sonographic evi- dence for an intrauterine pregnancy. Diagnostic vigilance is particularly recommended in in-vitro fertilization with multiple embryo transfer even in the case of intrauterine twin visualization. Finally management options are examined.