Retained viable single intrauterine pregnancy after vacuum aspiration for a dichorionic-diamniotic twin pregnancy

Retained viable intrauterine pregnancy is an infrequent complication of vacuum aspiration. We report a case of a retained single intrauterine pregnancy after an elective vacuum aspiration of a dichorionic-diamniotic twin gestation.

A patient presented to the emergency department reporting vaginal spotting, breast engorgement, and lower abdominal cramping for the previous 2 weeks. The patient had had an elective abortion 2 months previously. Transvaginal ultrasonography revealed an apparent twin gestational sac within the uterus. The presenting gestational sac contained a mixture of blood clot and tissue with no discernible fetal parts. The second sac contained a live fetus of approximately 15 weeks of gestation.

An underreported complication of vacuum aspiration is a retained viable intrauterine pregnancy. There is a role for postoperative ultrasonography in complicated cases such as twin gestations or in very early pregnancies to avoid retained products of conception or the infrequent case of retained viable intrauterine pregnancy.