Donald School Journal of Ultrasound in Obstetrics and Gynecology

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VOLUME 5 , ISSUE 4 ( October-December, 2011 ) > List of Articles

RESEARCH ARTICLE

Spontaneous Unilateral Tubal Twin Ectopic Pregnancy: A Case-Based Discussion and Assessment

Vaneesha Vallabh-Patel, Robert Vera, Gustavo Martell

Keywords : Tubal ectopic pregnancy,Transvaginal ultrasound,Color Doppler ultrasound,Three-dimensional ultrasound,Serum beta-hCG

Citation Information : Vallabh-Patel V, Vera R, Martell G. Spontaneous Unilateral Tubal Twin Ectopic Pregnancy: A Case-Based Discussion and Assessment. Donald School J Ultrasound Obstet Gynecol 2011; 5 (4):416-420.

DOI: 10.5005/jp-journals-10009-1219

License: CC BY-NC 4.0

Published Online: 01-09-2012

Copyright Statement:  Copyright © 2011; The Author(s).


Abstract

Introduction

Two percent of all 1st trimester pregnancies in the United States are ectopic. Transvaginal ultrasound is considered the mainstay in diagnosis. Color Doppler ultrasound can prove to be an added helpful modality in identifying ectopic pregnancies.

Case report

An 18-year-old nulliparous female presented with vaginal bleeding and lower abdominal pain. Pelvic exam revealed tenderness in the right adnexal region with elevated quantitative serum beta-hCG. A transvaginal ultrasound showed an echogenic ring adjacent to the right ovary and M-mode and color Doppler revealed two fetal heart tones. Color Doppler enabled visualization of randomly dispersed tubal arteries and heart activity of both embryos. A right salpingectomy was performed without complications and beta hCG levels returned to undetectable levels.

Conclusion

B mode ultrasound is a vital diagnostic tool in the detection of ectopic pregnancy. Color Doppler provides both morphologic and functional information essential for determining the optimal therapeutic strategy. Three-dimensional ultrasound with color and/or power Doppler has proven useful in both the initial diagnosis and follow-up of ectopic pregnancies especially in patients following assisted reproduction treatment.


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