Twin tubal pregnancy: a rising complication?
OBJECTIVE
To present four cases of twin tubal pregnancies and discuss possible etiologies. Twin tubal pregnancies are a rare event, with incidence rates estimated as 1 out of 725-1,580 of tubal pregnancies.


METHODS
Case series.


METHODS
Department of obstetrics and gynecology at a tertiary health care facility.


METHODS
All women with twin tubal pregnancy diagnosed and treated in the department during the years 2007-2009, according to electronic files and histologic reports.


METHODS
None.


METHODS
Artificial reproductive technique preceding twin tubal pregnancies


RESULTS
We diagnosed four twin pregnancies of 163 tubal pregnancies, an incidence of 2.4%. Of the four cases, two conceived after gonadotropin stimulation and intrauterine insemination. The third conceived following in vitro fertilization and intracytoplasmic sperm injection. The fourth was a spontaneous conception diagnosed as monochorial monoamniotic twin tubal pregnancy.


CONCLUSIONS
Twin tubal pregnancies may not be as rare as previously thought. Three of the four cases identified during a 2-year period followed artificial reproductive technique. We hope that this report will promote the study of the epidemiology of this event, improve diagnosis, and encourage the development of treatment modalities.
Svirsky
Ran
R
Department of Obstetrics and Gynecology, Assaf Harofe Medical Center, Zerifin, Israel.
Maymon
Ron
R
Vaknin
Zvi
Z
Mendlovic
Sonia
S
Weissman
Ariel
A
Halperin
Reuvit
R
Herman
Arie
A
Pansky
Moti
M
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology*; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D011274:Pregnancy, Tubal / Q000175:diagnosis / Q000453:epidemiology*; D027724:Reproductive Techniques, Assisted; D014427:Twins