Ectopic Twin Pregnancy : About A Case

Abstract

Unilateral tubal twin pregnancies occur in approximately 1 in 125,000 spontaneous pregnancies. Due to the lack of data, there are few recommendations on the appropriate management of a twin tubal ectopic pregnancy. We report a CLINICAL CASE of A 28-year-old woman, with type 1 diabetes on insulin and with no significant surgical or gynaecological history, the patient presented to the emergency room for metrorragia evolving for two days in a context of 6sa-2j amenorrhea. Clinical examination finds a hemodynamically stable patient, a depressible flexible abdomen with sensitivity to the right iliac pit and a slightly painful reversed uterus has mobilization with a moderate bleeding abundance of endo uterine origin. The emergency room urine pregnancy test was positive. Beta Hcg serum was 3,966 mUI/ml. Transvaginal ultrasound showed a reversed empty uterus, a fine and homogeneous endometrium of 7.8 mm with the presence at the right tubal level of two gestational bags measuring (7.2mm5.8mm) and (7mm-5.6 mm) with two embryos of 3.8mm and 3.6mm respectively, both had positive cardiac activity. at the douglas bag cul level, the presence of an effusion blade. the diagnosis of bi-amniotic bi-horoial bi-chorial ectopic pregnancy was made.a laparoscopy was performed with a right salpingectomy. postoperative evolution was favourable. Health care providers should have a high index of clinical suspicion for ectopic pregnancies. Unilateral tubal twin ectopic pregnancies, although rare, can be correctly diagnosed by transvaginal ultrasound. Laparoscopic salpingectomy provides an effective treatment for unilateral tubal twin gestation with a short recovery time. Due to the lack of data in the literature, there are few recommendations on the appropriate management of an ectuous ectopic twin pregnancy.