Combined intra- and extra-uterine gestations have been increasingly reported during the last few decades. Patients with a history of prior pelvic inflammatory disease and/or ovulation induction before pregnancy are thought to have greater risk for heterotopic gestations. We present a case of tubal pregnancy causing haematoma formation through the tube thus threatening a simultaneous intra-uterine pregnancy demonstrated by ultrasound scanning. The validity of serial ultrasound scannings is emphasized, and attention must be given for mutual heterotopic pregnancies by patients at risk.