Unilateral twin tubal pregnancy: a case report and review of the literature

Marta Betti; Patrizia Vergani; Gianluca Raffaello Damiani; Antonio Pellegrino; Edoardo Di Naro; Giuseppe Trojano; Cecilia Pirovano; Massimo Stomati; Matteo Loverro

doi:10.23750/abm.v89i3.6915

Unilateral twin tubal pregnancy: a case report and review of the literature

Authors

Marta Betti Department of Obstetrics and Gynaecology, ASTT Lecco, Ospedale Alessandro Manzoni, Lecco, Italy
Patrizia Vergani Department of Maternal Fetal Medicine, Fondazione MBBM, San Gerardo Hospital, University of Milano Bicocca, Monza, Italy
Gianluca Raffaello Damiani Department of Obstetrics and Gynaecology, ASTT Lecco, Ospedale Leopoldo Mandic, Merate, Italy
Antonio Pellegrino Department of Obstetrics and Gynaecology, ASTT Lecco, Ospedale Alessandro Manzoni, Lecco, Italy
Edoardo Di Naro Department of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, University of Bari, Aldo Moro, Bari, Italy
Giuseppe Trojano Department of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, University of Bari, Aldo Moro, Bari, Italy
Cecilia Pirovano Department of Obstetrics and Gynaecology, ASTT Lecco, Ospedale Alessandro Manzoni, Lecco, Italy
Massimo Stomati Department of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, ASL Brindisi, Francavilla Fontana Hospital, Brindisi, Italy
Matteo Loverro Department of Obstetrics and Gynaecology, ASTT Lecco, Ospedale Leopoldo Mandic, Merate, Italy

DOI: https://doi.org/10.23750/abm.v89i3.6915

Keywords:

Unilateral, twin tubal pregnancy, rare condition

Abstract

Background: Unilateral twin tubal pregnancy is an extremely rare condition, occurring in 1/20.000-250.000 pregnancies and represents a major health risk for reproductive-aged women, leading to even life-threatening complications. Aim: We present a case of a 31-year-old woman with unilateral twin tubal pregnancy, treated with methotrexate and then surgically because of failure, followed by review of the literature. Methods: Researches for relevant data were conducted utilizing multiple databases, including PubMed and Ovid. Results: The most common type of twin ectopic pregnancy is the heterotopic (1/7000 pregnancies) in which in which both ectopic and intrauterine pregnancy occur simultaneously. Expectant, medical and surgical therapy have similar success rates in correctly selected patients. Two prospective randomized trials did not identify any statistically significant differences between groups receiving MTX as a single dose or in multiple doses. Among the 106 cases reported in literature, methotrexate was tried just in 4 patients (3 unilateral and 1 bilateral) before ours. Details are reported in the table 1. Conclusion: The recent shift in the treatment of singleton ectopic pregnancies to the less invasive medical therapy might apply even in the case of twin implants.