Endovaginal sonographic diagnosis of ectopic twin gestation.

Abstract

Endovaginal sonography has permitted earlier diagnosis of ectopic pregnancy. Twin ectopic pregnancy is rare. Until now, antenatal diagnosis of twin ectopic pregnancy using endovaginal sonography had not been reported. Three cases of twin ectopic pregnancy diagnosed via the intracavitary probe are presented.

Live twin tubal ectopic pregnancy

“…It may be that the Q-hCG at presentation for twin ectopic pregnancies is higher than that of a singleton ectopic pregnancy, in which more than half present with Q-hCG less than 3000 mIU/mL [2]. This case concurs with a report by Ash et al [3] that, in the absence of an intrauterine gestational sac in the presence of a normally rising Q-hCG titer, a diagnosis of multiple ectopic gestation should be considered, among the other rare differential diagnoses.…”

Unilateral twin ectopic pregnancy managed with laparoscopic salpingectomy

“…Alarm bells should ring about the possibility of a multiple ectopic gestation (among the other rare differential diagnoses) when there is no demonstrable intrauterine gestational sac in the presence of abnormally rising HCG titres [3,4].…”

Spontaneous twin tubal ectopic gestation

“…9 It has also been surmised that early twinning of a fertilized zygote creates a larger than normal cell mass, retarding the transport along the damaged tube and leading to tubal implantation. 10 If this latter hypothesis were true, one would expect a disproportionate increase in the percentage of twin ectopic pregnancies in patient populations with scarred tubes. This assumption would also suggest that there would be a disproportionate percentage of monochorionic twins compared with dichorionic, diamniotic twins.…”