Keywords
Case reports
Heterotopic pregnancy
Tubal pregnancy
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To report a case of twin ectopic pregnancy, addressing epidemiological, clinical, diagnostic and therapeutic aspects, in order to bring relevant information to the scientific community. Case Detail: Patient G4P0A3, 32 years old, with 11 weeks and 5 days of gestation, arrived at the emergency room with vaginal bleeding, lower abdominal pain and malaise. After two days of hospitalization, a Beta HCG test showed a value greater than 10,000 mIU/mL and a transvaginal ultrasound revealed a complex cystic formation in the left adnexal, periovarian region, which, given the context, indicated an ectopic pregnancy. In addition, a complementary Venereal Disease Research Laboratory (VDRL) test was performed, which confirmed the diagnosis of syphilis. The next day, the patient underwent laparotomy, followed by resection of the ectopic pregnancy and right salpingectomy, which confirmed the twin ectopic pregnancy. Final considerations: This case highlights the importance of early diagnosis, appropriate clinical management and surgical treatment in severe cases to reduce complications/mortality and ensure a better prognosis for affected patients. The combination of symptoms, such as abdominal pain and vaginal bleeding, with complementary tests, such as beta hCG and transvaginal ultrasound, is essential for identification and effective treatment.
References
ALKATOUT I, et al. Clinical Diagnosis and Treatment of Ectopic Pregnancy. Obstetrical & Gynecological Survey, 2013; 68(8): 571–581.
BERNARDES LS, et al. Unilateral twin tubal ectopic pregnancy: Case report. Revista Médica de Minas Gerais, 2018; 28.
CHONG KY, et al. A core outcome set for future research in ectopic pregnancy: an international consensus development study. Fertility and Sterility, 2023; 119(5): 804–812.
FARREN J. et al. Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. American Journal of Obstetrics and Gynecology,2020; 222(4):367.e1-367.e22.
HENDRIKS E. et al. Ectopic Pregnancy: Diagnosis and Management. Am Fam Physician, 2020; 101(10): 599-606.
HOORSHAD N. et al. Bilateral tubal ectopic pregnancy following induction ovulation can be missed in emergent ultrasonography: Case report. International Journal of Surgery Case Reports, 2024; 121: 109863.
JEFFERS K. et al. Updates in emergency medicine: Ectopic pregnancy. The American journal of emergency medicine, 2024;85: 90–97.
LAMUWALLA M. et al. Interstitial ectopic pregnancy, a rare clinical phenomenon diagnosed asymptomatically on routine work up in Tanzania: Case report. International Journal of Surgery Case Reports, 2024; 126:110688.
LEITE JF. et al. Local management with methotrexate of cesarean scar ectopic pregnancy with live embryo guided by transvaginal ultrasound: A case report. Revista da Associação Médica Brasileira, 2016; 62(2): 184–185.
LEZIAK M. et al. Future Perspectives of Ectopic Pregnancy Treatment—Review of Possible Pharmacological Methods. International Journal of Environmental Research and Public Health, 2022; 19(21): 14230.
LOMBARDI W. et al. Laparotomia de urgência por gravidez gemelar tubária: um raro relato de caso. Brazilian Journal of Health Review, 2023;6(3):9477–83.
MARTA B. et al. Unilateral twin tubal pregnancy: a case report and review of the literature. Acta Biomed, 2018; 89(3): 423-427.
MULLANY K. et al. Overview of ectopic pregnancy diagnosis, management, and innovation. Women’s Health, 2023; 19(19): 174550572311603.
NEPAL P. et al. Utility of MRI in Management of a Rare Case of Unilateral Dichorionic-Diamniotic Twin Tubal Ectopic Pregnancy. Current Problems in Diagnostic Radiology, 2021; 50(4): 551–553.
PÉREZ-MARTÍN L. et al. Tratamiento laparoscópico de na gestación ectópica tubárica gemelar monocorial monoaminiótica espotánea. Caso clínico. Ginecol Obstet Mex, 2013; 81(10), p.612-5.
PIRES, JEB. et al. Gestação gemelar ectópica ovariana: um raro relato de caso. Brazilian Journal of Surgery and Clinical Research – BJSCR, 2020; 32(1): 2317-4404.
POSSER AO. et al. Gravidez ectópica tubária bilateral: relato de caso. Revista Brasileira de Ginecologia e Obstetrícia, 1998; 20(6).
SAIF M. et al. Rectal ectopic pregnancy: A case report. International Journal of Surgery Case Reports, 2024; 119: 109798.
SAMHA R. et al. A unilateral twin ectopic pregnancy in the fallopian tube: A rare case report. International Journal of Surgery Case Reports, 2023; 111: 108833.
TAVARES BVG. et al. Changing paradigms in the initial treatment of ectopic pregnancy at a university hospital in Brazil. Revista brasileira de ginecologia e obstetrícia: revista da Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2023;45(4):192–200.
YAMANE D. et al. Twin ectopic pregnancy. The Journal of emergency medicine, 2015;48(6):13940.
ZHAO X. et al. Modeling human ectopic pregnancies with trophoblast and vascular organoids. Cell Reports, 2023; 42(6):112546.