A live tubal twin pregnancy

Excerpt

A 30-year-old woman (gravida 0, para 0) presented to the outpatient department with a 24-day history of vaginal bleeding. Her last menstrual period was 56 days before presentation. The patient denied that the pregnancy had been created by assisted reproduction. At presentation, the patient was hemodynamically stable. Physical examination revealed right adnexal tenderness. The serum level of β-human chorionic gonadotropin was 27,036 IU/L. Ultrasonography revealed an adnexal mass separated from the right ovary containing one gestational sac and two embryos with cardiac activities (Fig. 1), thus indicating a live tubal twin pregnancy. During emergent laparoscopy, a blue, distended right fallopian tube was observed (Fig. 2a); this was surgically removed. Gross anatomy revealed two intact amniotic sacs (Fig. 2b), each containing an embryo (Fig. 2c, d). The probability of tubal twin pregnancy following spontaneous conception is estimated to be 1 in 125,000 pregnancies. Our patient had an uneventful postoperative course.

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