title: Unilateral tubal twin ectopic pregnancy treated with single-dose methotrexate.
abstract: BACKGROUND
  Spontaneous tubal twin pregnancy is a rare condition with an incidence of 1 in every 125,000 pregnancies. We present the case of a unilateral tubal twin ectopic pregnancy treated with single-dose methotrexate.
  
  
  METHODS
  A 26-year-old nulliparous woman was admitted to our clinic with a complaint of vaginal bleeding and leftside pelvic pain. Her serum β-human chorionic gonadotropin (β-hCG) level was 18,780 mIU/mL and ultrasound revealed tubal twin pregnancy of 7 weeks' gestation. Because her vital signs were stable and no sign of tubal rupture was present, we performed single-dose (100 mg) methotrexate intramuscularly. In the follow-up, serum β-hCG levels were found to be 7,600 mIU/ml on day 7, 948 mIU/ml on day 20, 126 mIU/ml on day 26 and <10 mIU/ml on day 42.
  
  
  CONCLUSIONS
  Methotrexate theraphy may be preferred in tubal twin ectopic pregnancies when the vital signs of the patient are stable and the fetal cardiac activities are negative.
authors.affiliation: Department of Obstetrics and Gynecology, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turkey. drdenizarikan@hotmail.com
authors.forename: Deniz Cemgil
authors.initials: DC
authors.lastname: Arikan
authors.forename: Gurkan
authors.initials: G
authors.lastname: Kiran
authors.forename: Ayhan
authors.initials: A
authors.lastname: Coskun
authors.forename: Bulent
authors.initials: B
authors.lastname: Kostu
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D004107:Dilatation and Curettage; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008727:Methotrexate / Q000008:administration & dosage*; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011274:Pregnancy, Tubal / Q000097:blood / Q000628:therapy*; D014427:Twins
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate