title: Ectopic twin pregnancy in cesarean scar after in vitro fertilization/embryo transfer: case report.
abstract: OBJECTIVE
  To present two cases of ectopic twin pregnancy in a Cesarean section scar following IVF-embryo transfer.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Tertiary referral case center.
  
  
  METHODS
  Two women who had ectopic twin pregnancy in a Cesarean section scar, in both cases following IVF and embryo transfer.
  
  
  METHODS
  Three-dimensional power Doppler ultrasound and diagnostic hysteroscopy were performed for early recognition and treatment.
  
  
  METHODS
  Prevention of pregnancy complications such as hemorrhage, uterine rupture, and preservation of fertility.
  
  
  RESULTS
  Case 1: diagnosis was made in a 31-year-old woman after IVF; she was managed with laparotomy excision of the twin pregnancy. Case 2: an early such pregnancy was diagnosed in a 37-year-old woman following IVF. She was treated successfully with hysteroscopy and laparoscopic surgery.
  
  
  CONCLUSIONS
  Because ectopic pregnancy in a Cesarean scar carries high risk of uterine rupture and uncontrollable hemorrhage, such a twin pregnancy presumably carries similar risks. Focused application of high-resolution ultrasound and diagnostic hysteroscopy may help lead to early recognition of ectopic twin pregnancy in a Cesarean scar and prevention of complications such as hemorrhage and uterine rupture.
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.
authors.forename: Ho-Yen
authors.initials: HY
authors.lastname: Chueh
authors.forename: Po-Jen
authors.initials: PJ
authors.lastname: Cheng
authors.forename: Chia-Wei
authors.initials: CW
authors.lastname: Wang
authors.forename: Sheng-Wen
authors.initials: SW
authors.lastname: Shaw
authors.forename: Chyi-Long
authors.initials: CL
authors.lastname: Lee
authors.forename: Yung-Kuei
authors.initials: YK
authors.lastname: Soong
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000209:etiology*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015907:Hysteroscopy; D010535:Laparoscopy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D011272:Pregnancy, Multiple; D016896:Treatment Outcome; D014427:Twins; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014619:Vacuum Curettage