Unilateral tubal twin ectopic pregnancy treated with single-dose methotrexate.
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.
Arikan
Deniz Cemgil
DC
Department of Obstetrics and Gynecology, Kahramanmaras Sutcu Imam University, Kahramanmaraş, Turkey. drdenizarikan@hotmail.com
Kiran
Gurkan
G
Coskun
Ayhan
A
Kostu
Bulent
B
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
D000020:Abortifacient Agents, Nonsteroidal; D018997:Chorionic Gonadotropin, beta Subunit, Human; D008727:Methotrexate