Unilateral live twin ectopic pregnancy: a case report

Yıl 2015, Cilt: 46 Sayı: 3, 110 - 112, 16.03.2015

Evrim Bostancı Ergen , Ayşen Boza Mehmet Şentürk , Semra Kayataş Eser

https://doi.org/10.16948/zktb.97761

Öz

Introduction: Twin ectopic pregnancy is a rare condition with an incidence of 1 in every 200 ectopic pregnancies. We present a case of a twin, live, unilateral tubal ectopic pregnancy treated with laparoscopic salpingectomy.

Case: A 42-year-old nulliparous woman was admitted to our clinic with a complaint of vaginal bleeding and pelvic pain. Her serum ß-human chorionic gonadotropin (ß-hCG) level was 4500 mIU/ mL and transvaginal ultrasound revealed live tubal twin pregnancy of 7 weeks’ gestation. A laparoscopic salphingostomy was planned but salpingectomy was performed since active bleeding was noticed from tube during the operation. None complication was not occurred after operation. Patient is discharged one day after operation.

Conclusion: Viable twin ectopic pregnancy with is a rare condition. If not treated properly, it can lead to life-threatening complications.

Anahtar Kelimeler

Twin ectopic pregnancy, laparoscopy, unilateral, live

Unilateral canlı ikiz ektopik gebelik: olgu sunumu

Öz

Giriş: İkiz ektopik gebelik; her 200 ektopik gebeliğin birinde saptanan, nadir bir durumdur. Burada laparoskopik salpenjektomi ile tedavi edilen, kalp atımları pozitif unilateral ikiz ektopik gebelik olgusunu sunduk.

Olgu: 42 yaşında nullipar hasta kliniğimize vajinal kanama ve pelvik ağrı şikayetleri ile başvurdu. Hastanın ß-hCG serum seviyesi 4500mIU/mL idi. Yapılan transvajinal ultrasonda 7 haftalık gestasyon kesesine sahip canli ikiz ektopik gebelik saptandı. Laparoskopik salpingostomi planlanan hastanın operasyon sırasında tubal aktif kanamanın durdurulamaması nedeniyle salpenjektomi yapıldı. Operasyondan sonra komplikasyon gelişmedi. Hasta ameliyattan 1 gün sonra taburcu edildi.

Sonuç: Kalp atımı pozitif unilateral ikiz gebeliğe çok nadir rastlanır. Uygun tedavi edilmezse yaşamı tehdit eden komplikasyonlara yol açabilir.

Anahtar Kelimeler

ikiz ektopik gebelik, tek taraflı, canlı

Kaynakça

• Breen JL. A 21 year survey of 654 ectopic pregnancies. American Journal of Obstetrics &Gynecology. 1970;106(7):1004–1019.
• Abrams RA, Kanter AE. Bilateral simultaneous extrauterine pregnancy. American Journal of Obstetrics & Gynecology. 1948; 56(6):1198–1200.
• Hois EL, Hibbeln JF, Sclamberg JS. Spontaneous twin tubal ectopic gestation. J Clin Ultrasound. 2006;34: 352-5.
• Parker J, Hewson AD, Calder-Mason T, Lai J. Transvaginal ultrasound diagnosis of a live twin tubal ectopic pregnancy. Australasian Radiology. 1999;43(1):95–97.
• Shwayder JM, Mahoney V, Bersinger DE. Unilateral twin ectopic pregnancy managed by operative laparoscopy. A case report. J Reprod Med. 1993;38:314-6.
• Arey LB. The cause of tubal pregnancy and tubal twinning. Am J Obstet Gynecol. 1923;5: 163-7.
• Storch MP, Petrie RH. Unilateral tubal twin gestation. Am J Obstet Gynecol. 1976;125:1148.
• Neuman WL, Ponto K, Farber RA, et al. DNA analysis of unilateral twin ectopic gestation. Obstet Gynecol 1990; 75:479.
• M George, S Nadarajah, CL Ong Unilateral Twin Ectopic Pregnancy. Coll Radiol, 2010 - hkjr.org
• Gualandi M, Steemers N, de Keyser JL. First reported case of preoperative ultrasonic diagnosis and laparoscopic treatment of unilateral, twin tubal pregnancy. Rev Fr Gynecol Obstet. 1994;89:134-6. French.
• Karanjgaokar V, Shah P, Nicholson Y, Spence-Jones C. Laparoscopic management of a ruptured unilateral live twin ectopic pregnancyin a Jehovah's Witness. J Obstet Gynaecol. 2009 Aug;29(6):557-8. doi: 10.1080/01443610903074366.
• Longoria TC, Stephenson ML, Speir VJ. Live unilateral twin ectopic pregnancy in a fallopian tube remnant after previous ipsilateral salpingectomy. J Clin Ultrasound. 2014 Mar-Apr;42(3):169-71. doi: 10.1002/jcu.22074. Epub 2013 Jul 26.
• Gabrielli S, Marconi R, Ceccarini M et al. 2006. Trans-vaginal and three dimensional ultrasound diagnosis of twin tubal pregnancy. Prenatal Diagnosis 26: 91–93.
• Eddib A, Olawaiye A, Withiam-Leitch M et al. 2006. Live twin tubal ectopic pregnancy. International Journal of Gynecology and Obstetrics 93: 154–155.
• Bickell NA, Bodian C, Anderson RM, Kase N. Time and the risk of ruptured tubal pregnancy. Obstet Gynecol. 2004 Oct;104(4):789-94.
• Tam T, Khazaei A. Spontaneous unilateral dizygotic twin tubal pregnancy. J Clin Ultrasound 2009 Feb;37(2):104-6. doi: 10. 1002/jcu.20495.
• RCOG. 2004. Guideline No. 21: The management of tubal pregnancy, London: RCOG Press.