Ovarian Pregnancy & Uterine Pregnancy: Understanding the Complexities

Question
I have a friend that went to the er lat night...she was told she was infact pregnant however the fetus was inside an ovarian cyct and it was bleeding...the wierd thing is she has a yolk sac in her uterus, but the ultra sound tech could not see the baby!  Is this possible??  Please help, my friend is heartbroken and we are both scared.  Is it possible the d could have been wrong, she is 5 wks so i think you should be able to detect something...?  Could it have been twins?

Answer
Dear Chanda

An intrauterine pregnancy may coexist at the same time with an extrauterine pregnancy, a case known as heterotopic pregnancy. Although rare, it is more common to occur if an IVF technique is used to achieve pregnancy. A yolk sac may not be visible in the uterus if she is only 5 weeks amenorrehic but if an ovarian pregnancy is clearly diagnosed, by an experienced gynecologist, she should be operated upon immediately without delay for fear of hemorrhage.

Only experienced gynecologist can diagnose ovarian pregnancy and be sure that what is known as Spieglberg'scriteria are f
ulfilled to make such diagnosis. At many ocassions a pregnancy distal in the tube was mistaken for an ovarian 1.

Good Luck