Monochorionic diamniotic twin cervical ectopic pregnancy following assisted conception: a case report.
BACKGROUND
Ectopic pregnancy is a leading cause of maternal mortality. Its incidence has progressively increased in recent years. Assisted conception techniques are associated with a significantly higher rate of ectopic pregnancies. Cervical ectopic pregnancies are very rare, accounting for < 1% of all ectopic pregnancies.


METHODS
A 41-year-old, Caucasian woman presented for routine transvaginal scan at 6 weeks' gestation following a single embryo transfer as part of in vitro fertilization (IVF) follow-up. This revealed a monochorionic diamniotic twin pregnancy within the cervix. Serum beta-hCG concentration was 18,470 IU/L, and she reported only a mild brown-stained vaginal discharge. She was counseled regarding the risks of this pregnancy and was managed medically, receiving oral mifepristone and systemic methotrexate. She was subsequently monitored with serial serum beta-hCG measurements and transvaginal ultrasonography. After 6 weeks, due to the slow serum beta-hCG decline and lack of spontaneous menstruation, she was counseled regarding the potential risks of the persistent pregnancy and underwent suction evacuation.


CONCLUSIONS
This case is an example of a complication of LVF. To the best of our knowledge and following a search of the Medline database, this is the only case of monochorionic twin pregnancy located within the cervical canal.
Department of Obstetrics and Gynecology, St. Mary's Hospital, Oxford Road, Manchester, UK. dranev@doctors.org.uk
Ivan
I
Anev
Jean
J
Wang
Manisha
M
Palep-Singh
Mourad W
MW
Seif
D000328:Adult; D002584:Cervix Uteri; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D059285:Pregnancy, Twin; D056826:Single Embryo Transfer / Q000009:adverse effects*; D014427:Twins; D016216:Ultrasonography, Prenatal
D018997:Chorionic Gonadotropin, beta Subunit, Human