Heterotopic pregnancy after in vitro fertilization.

Maternal mortality related to ruptured ectopic pregnancy remains elevated. A case is presented of heterotopic pregnancy in a patient whose pregnancy was assisted with in vitro fertilization. The patient's diagnosis was delayed, potentially because of lack of tachycardia associated with the hypotension. The clinical presentation of heterotopic pregnancy is similar to that of ectopic pregnancy. The risk factors for heterotopic pregnancy are the same as those for ectopic pregnancy, with the addition of in vitro fertilization, which increases the risk substantially.