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Rare Case of Ruptured Live Tubal Ectopic Twin Pregnancy

Received: 22 April 2022     Accepted: 7 May 2022     Published: 24 May 2022
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Abstract

This article aims to report a rare case of a primigravida with live twin ectopic pregnancy at 12 weeks gestation, seen at Al Qassimi Women & Children Hospital, Sharjah, which was successfully diagnosed and managed upon arrival with no maternal morbidity. The patient presented in Emergency department with severe abdominal pain, by her dates she was in late first trimester of pregnancy with no prior early pregnancy scan. She was tachycardic with generalized abdominal tenderness with guarding and rigidity on examination. Bedside ultrasound was suspicious of twin ectopic with hemoperitoneum; findings were confirmed urgently with scan in radiology department. In view of patient’s condition, urgent laparotomy was done which showed ruptured right tubal ampullary twin pregnancy with hemoperitoneum. Right salpingectomy was done, 2 units of blood were transfused intraoperatively. She has an uneventful postoperative period was discharged in good condition on the third day. his case stresses on the importance of being extra vigilant in a busy Emergency department where low risk late first trimester pregnancies present with acute abdomen with no prior scans need urgent ultrasound to identify this rare diagnosis of twin ectopic and manage effectively and rapidly to avoid major morbidity to the patient.

Published in World Journal of Medical Case Reports (Volume 3, Issue 2)
DOI 10.11648/j.wjmcr.20220302.14
Page(s) 29-32
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Ectopic, Early Pregnancy, Emergency, Ruptured Ectopic, Hemoperitoneum, Twin Ectopic

References
[1] Chang-Ihll KimTae-Yeem LeeSung-Taek ParkHong-Bae Kimand Sung-Ho ParkA rare case of spontaneous live unilateral twin tubal pregnancy with both fetuses presenting with heart activities and a literature review. Obstet Gynecol Sci. 2018 Mar; 61 (2): 274–277.
[2] D Goswami N Agrawal V Arora. Twin Tubal Pregnancy: A Large Unruptured Ectopic Pregnancy. J Obstet Gynaecol Res. 2015 Nov; 41 (11): 1820-2.
[3] Parker J, Hewson AD, Calder-Mason T, Lai J. Transvaginal ultrasound diagnosis of a live twin tubal ectopic pregnancy. Australas Radiol. 1999; 43: 95–97.
[4] Teresa Tam Ali Khazaei. Spontaneous Unilateral Dizygotic Twin Tubal Pregnancy. J Clin Ultrasound. 2009 Feb; 37 (2): 104-6.
[5] Karanjgaokar V, Shah P, Nicholson Y, Spence-Jones C. Laparoscopic management of a ruptured unilateral live twin ectopic pregnancy in a Jehovah’s Witness. J Obstet Gynaecol. 2009; 29: 557–558.
[6] Gamzu R, Almog B, Levin Y, et al. The ultrasonographic appearance of tubal pregnancy in patients treated with methotrexate. Hum Reprod 2002; 17: 2585–7.
[7] CJ Seak, MDZ N Leonard Goh, MBBSA C Wong, MBBSJ CY Seak, MDand C-K Seak. Unilateral live twin tubal ectopic pregnancy presenting at 12 weeks of gestation-A case report. Medicine (Baltimore). 2019 Sep; 98 (38): e17229De Los Ríos.
[8] De Los Ríos JF, Castañeda JD, Miryam A. Bilateral ectopic pregnancy. J Minim Invasive Gynecol. 2007; 14: 419–427.
[9] Chukus, Anjeza et al. “Uncommon Implantation Sites of Ectopic Pregnancy: Thinking beyond the Complex Adnexal Mass.” RadioGraphics 2015; 35 (3): 946-959.
[10] Betti, Marta et al. “Unilateral twin tubal pregnancy: a case report and review of the literature.” Acta bio-medica: Atenei Parmensis 2018; 89 (3): 423-427.
[11] Lee, Robert et al. “Diagnosing ectopic pregnancy in the emergency setting”. Ultrasonography. 2018; 37 (1): 78-87.
[12] Bickell NA, Bodian C, Anderson RM, et al. Time and the risk of ruptured tubal pregnancy. Obstet Gynecol 2004; 104: 789–94.
[13] Yamane D, Stella M, Goralnick E. Twin ectopic pregnancy. J Emerg Med. 2015 Jun; 48 (6): e139–40.
[14] Goswami D, Agrawal N, Arora V. Twin tubal pregnancy: A large unruptured ectopic pregnancy. J Obstet Gynaecol Res. 2015; 41 (11): 1820–2.
Cite This Article
  • APA Style

    Shalini Malhotra, Safaa Khalil, Sweety Kumari. (2022). Rare Case of Ruptured Live Tubal Ectopic Twin Pregnancy. World Journal of Medical Case Reports, 3(2), 29-32. https://doi.org/10.11648/j.wjmcr.20220302.14

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    ACS Style

    Shalini Malhotra; Safaa Khalil; Sweety Kumari. Rare Case of Ruptured Live Tubal Ectopic Twin Pregnancy. World J. Med. Case Rep. 2022, 3(2), 29-32. doi: 10.11648/j.wjmcr.20220302.14

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    AMA Style

    Shalini Malhotra, Safaa Khalil, Sweety Kumari. Rare Case of Ruptured Live Tubal Ectopic Twin Pregnancy. World J Med Case Rep. 2022;3(2):29-32. doi: 10.11648/j.wjmcr.20220302.14

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  • @article{10.11648/j.wjmcr.20220302.14,
      author = {Shalini Malhotra and Safaa Khalil and Sweety Kumari},
      title = {Rare Case of Ruptured Live Tubal Ectopic Twin Pregnancy},
      journal = {World Journal of Medical Case Reports},
      volume = {3},
      number = {2},
      pages = {29-32},
      doi = {10.11648/j.wjmcr.20220302.14},
      url = {https://doi.org/10.11648/j.wjmcr.20220302.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20220302.14},
      abstract = {This article aims to report a rare case of a primigravida with live twin ectopic pregnancy at 12 weeks gestation, seen at Al Qassimi Women & Children Hospital, Sharjah, which was successfully diagnosed and managed upon arrival with no maternal morbidity. The patient presented in Emergency department with severe abdominal pain, by her dates she was in late first trimester of pregnancy with no prior early pregnancy scan. She was tachycardic with generalized abdominal tenderness with guarding and rigidity on examination. Bedside ultrasound was suspicious of twin ectopic with hemoperitoneum; findings were confirmed urgently with scan in radiology department. In view of patient’s condition, urgent laparotomy was done which showed ruptured right tubal ampullary twin pregnancy with hemoperitoneum. Right salpingectomy was done, 2 units of blood were transfused intraoperatively. She has an uneventful postoperative period was discharged in good condition on the third day. his case stresses on the importance of being extra vigilant in a busy Emergency department where low risk late first trimester pregnancies present with acute abdomen with no prior scans need urgent ultrasound to identify this rare diagnosis of twin ectopic and manage effectively and rapidly to avoid major morbidity to the patient.},
     year = {2022}
    }
    

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    AU  - Shalini Malhotra
    AU  - Safaa Khalil
    AU  - Sweety Kumari
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    DO  - 10.11648/j.wjmcr.20220302.14
    T2  - World Journal of Medical Case Reports
    JF  - World Journal of Medical Case Reports
    JO  - World Journal of Medical Case Reports
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    UR  - https://doi.org/10.11648/j.wjmcr.20220302.14
    AB  - This article aims to report a rare case of a primigravida with live twin ectopic pregnancy at 12 weeks gestation, seen at Al Qassimi Women & Children Hospital, Sharjah, which was successfully diagnosed and managed upon arrival with no maternal morbidity. The patient presented in Emergency department with severe abdominal pain, by her dates she was in late first trimester of pregnancy with no prior early pregnancy scan. She was tachycardic with generalized abdominal tenderness with guarding and rigidity on examination. Bedside ultrasound was suspicious of twin ectopic with hemoperitoneum; findings were confirmed urgently with scan in radiology department. In view of patient’s condition, urgent laparotomy was done which showed ruptured right tubal ampullary twin pregnancy with hemoperitoneum. Right salpingectomy was done, 2 units of blood were transfused intraoperatively. She has an uneventful postoperative period was discharged in good condition on the third day. his case stresses on the importance of being extra vigilant in a busy Emergency department where low risk late first trimester pregnancies present with acute abdomen with no prior scans need urgent ultrasound to identify this rare diagnosis of twin ectopic and manage effectively and rapidly to avoid major morbidity to the patient.
    VL  - 3
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Author Information
  • Department of Obstetrics & Gynaecology, Al Qassimi Women & Children Hospital, Sharjah, UAE

  • Department of Radiology, Al Qassimi Women & Children Hospital, Sharjah, UAE

  • Department of Obstetrics & Gynaecology, Al Qassimi Women & Children Hospital, Sharjah, UAE

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