Ectopic twin pregnancy in cesarean scar after in vitro fertilization/embryo transfer: case report
Ho-Yen Chueh1, Po-Jen Cheng, Chia-Wei Wang
1Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan, Republic of China.
Objective:
To present two cases of ectopic twin pregnancy in a Cesarean section scar following IVF-embryo transfer.
Design:
Case report.
Setting:
Tertiary referral case center.
Patient(S):
Two women who had ectopic twin pregnancy in a Cesarean section scar, in both cases following IVF and embryo transfer.
Intervention(S):
Three-dimensional power Doppler ultrasound and diagnostic hysteroscopy were performed for early recognition and treatment.
Main Outcome Measure(S):
Prevention of pregnancy complications such as hemorrhage, uterine rupture, and preservation of fertility.
Result(S):
Case 1: diagnosis was made in a 31-year-old woman after IVF; she was managed with laparotomy excision of the twin pregnancy. Case 2: an early such pregnancy was diagnosed in a 37-year-old woman following IVF. She was treated successfully with hysteroscopy and laparoscopic surgery.
Conclusion(S):
Because ectopic pregnancy in a Cesarean scar carries high risk of uterine rupture and uncontrollable hemorrhage, such a twin pregnancy presumably carries similar risks. Focused application of high-resolution ultrasound and diagnostic hysteroscopy may help lead to early recognition of ectopic twin pregnancy in a Cesarean scar and prevention of complications such as hemorrhage and uterine rupture.
