title: Twin tubal pregnancy: A large unruptured ectopic pregnancy.
abstract: Twin ectopic pregnancy is a rare occurrence, with an estimated incidence of 1 in 20 000 spontaneous pregnancies. We describe a case of unilateral twin ectopic pregnancy in which the gravid fallopian tube showed no signs of tubal rupture despite marked tubal distension. A 25-year-old woman presented with clinical features suggestive of large right-sided tubal ectopic pregnancy. Serum β-human chorionic gonadotropin was 10 800 IU/mL. Laparotomy revealed markedly distended right fallopian tube. There was no hemoperitoneum. The tube contained twin gestational sacs. The crown-rump length of the embryos was 2 cm. The ectopic gestation was thus unique, in that despite marked tubal distension, the trophoblastic invasion was not significant to cause tubal rupture. There may be a role for medical management based on individual gestational sac size in selected cases of twin tubal pregnancy in which there is no evidence of hemoperitoneum.
authors.affiliation: Department of Obstetrics and Gynecology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Deepti
authors.initials: D
authors.lastname: Goswami
authors.affiliation: Department of Obstetrics and Gynecology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Nidhi
authors.initials: N
authors.lastname: Agrawal
authors.affiliation: Department of Obstetrics and Gynecology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Vrinda
authors.initials: V
authors.lastname: Arora
mesh_terms: D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000652:urine; D005260:Female; D006801:Humans; D007813:Laparotomy; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery / Q000652:urine; D059285:Pregnancy, Twin; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human
keywords: ectopic pregnancy; tubal pregnancy; twin pregnancy