Unilateral Twin Ectopic Pregnancy in a Patient With a History of Multiple Sexually Transmitted Infections

Rolle, Charles J.; Wai, Clifford Y.; Bawdon, Roger; Santos-Ramos, Rigoberto; Hoffman, Barbara

doi:https://doi.org/10.1155/IDOG/2006/10306

Infectious Diseases in Obstetrics and Gynecology

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Case Report | Open Access

Volume 2006 | Article ID 010306 | https://doi.org/10.1155/IDOG/2006/10306

Unilateral Twin Ectopic Pregnancy in a Patient With a History of Multiple Sexually Transmitted Infections

Charles J. Rolle,¹Clifford Y. Wai,¹Roger Bawdon,¹Rigoberto Santos-Ramos,¹and Barbara Hoffman¹

Received03 Apr 2004

Revised03 Jun 2005

Accepted31 Jul 2005

Published14 Jun 2006

Abstract

Background. The incidence of unilateral twin ectopic pregnancy is a rare condition. Several factors increase the risk of ectopic pregnancy, the most important of which is pelvic inflammatory disease, followed by operative trauma, congenital anomalies, tumors, and adhesions resulting in anatomically distorted fallopian tubes. We present a case of a woman with a history of four confirmed sexually transmitted infections (STIs) including Chlamydia trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2, and Treponema pallidum. The case illustrates the potential impact of sexually transmitted infections (STIs) on the risk of a twin ectopic pregnancy. Case. A 24-year-old primigravida, presented with an unknown last menstrual period, lower abdominal pain, watery vaginal discharge, and vaginal spotting. During this hospitalization, serum β-HCG testing was 263 mIU/mL and transvaginal ultrasonographic examination suggested a nonviable unilateral twin ectopic pregnancy. At exploratory laparotomy, a 10 cm mass involving the right fallopian tube and ovary was excised. Pathological evaluation of the specimen identified a monochorionic, diamnionic twin ectopic pregnancy within the fallopian tube. Conclusions Patients with a history of multiple (STIs) are known to be at risk for the development of chronic pelvic infection and postinflammatory scarring. The resulting distortion of the normal tubal anatomy leads to an increased risk of an uncommon presentation of ectopic pregnancy.

References

D De Ott, “A case of unilateral tubal twin gestation,” Annales de Gynécologie et d'Obstétrique, vol. 36, p. 304, 1891.
View at: Google Scholar
R A Abrams and A E Kanter, “Bilateral simultaneous extrauterine pregnancy,” American Journal of Obstetrics & Gynecology, vol. 56, no. 6, pp. 1198–1200, 1948.
View at: Google Scholar
J L Breen, “A 21 year survey of 654 ectopic pregnancies,” American Journal of Obstetrics & Gynecology, vol. 106, no. 7, pp. 1004–1019, 1970.
View at: Google Scholar
J Parker, A D Hewson, T Calder-Mason, and J Lai, “Transvaginal ultrasound diagnosis of a live twin tubal ectopic pregnancy,” Australasian Radiology, vol. 43, no. 1, pp. 95–97, 1999.
View at: Google Scholar
L B Arey, “The cause of tubal pregnancy and tubal twinning,” American Journal of Obstetrics & Gynecology, vol. 5, pp. 163–167, 1923.
View at: Google Scholar
W M Bressers, A W Ericksson, P J Kostense, and P Parisi, “Increasing trend in the monozygotic twinning rate,” Acta Geneticae Medicae et Gemellologiae, vol. 36, no. 3, pp. 397–408, 1987.
View at: Google Scholar
K D Wenstrom, C H Syrop, D G Hammitt, and B J Van Voorhis, “Increased risk of monochorionic twinning associated with assisted reproduction,” Fertility and Sterility, vol. 60, no. 3, pp. 510–514, 1993.
View at: Google Scholar
E NT Goker, E Tavmergen, H T Ozcakir, R Levi, and S Adakan, “Unilateral ectopic twin pregnancy following an IVF cycle,” The Journal of Obstetrics and Gynaecology Research, vol. 27, no. 4, pp. 213–215, 2001.
View at: Google Scholar
A A Schinzel, D W Smith, and J R Miller, “Monozygotic twinning and structural defects,” The Journal of Pediatrics, vol. 95, no. 6, pp. 921–930, 1975.
View at: Google Scholar
H C Gérard, P J Branigan, G R Balsara, C Heath, S S Minassian, and A P Hudson, “Viability of Chlamydia trachomatis in fallopian tubes of patients with ectopic pregnancy,” Fertility and Sterility, vol. 70, no. 5, pp. 945–948, 1998.
View at: Google Scholar

Copyright

Copyright © 2006 Charles J. Rolle et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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