Martin A, Balachandar K, Bland P. Management of a spontaneously conceived live unilateral twin ectopic pregnancy in Australia: A case report.
Case Rep Womens Health 2021;
30:e00300. [PMID:
33665142 PMCID:
PMC7905450 DOI:
10.1016/j.crwh.2021.e00300]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction
Unilateral twin ectopic pregnancies are exceedingly rare, occurring in one in every 250,000 pregnancies. While clear guidelines exist regarding the management of singleton ectopic pregnancies, no such recommendations exist for multi-gestational ectopic pregnancies.
Case presentation
A 36-year-old woman, gravida 3 para 1, presented to the emergency department at 6 weeks and 4 days of gestation with a live twin ectopic pregnancy diagnosed on a dating ultrasound scan. Given the high likelihood of rupture, she underwent a laparoscopic salpingectomy and was discharged home the following day. The patient was followed-up with weekly serum β-hCG tests, to ensure there was no remaining pregnancy.
Discussion
While the morbidity and mortality associated with singleton ectopic pregnancies has gradually declined, the risk of rupture is higher in twin ectopic pregnancies and rupture is estimated to occur in 30–50% of cases. Surgical intervention remains the mainstay of treatment for these pregnancies.
Unilateral live twin ectopic pregnancies are extremely rare.
Five of 21 previously reported cases of unilateral live ectopic pregnancy were asymptomatic on diagnosis.
No international guidelines specifically address multiple ectopic pregnancies.
There are no reported cases of medical management of live unilateral ectopic pregnancy.
Surgical intervention appears the most appropriate course of management.
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