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2012-12-10-14 Ectopic pregnancy, twin, cervical ©Jayprakash Shah

Ectopic pregnancy, twin, cervical 

Rajni Fetal Medicine center, Ahmedabad, India

Case report:
Mrs ABC, G3P2, having 2 kids of her own, had conceived as surrogate mother. Her previous 2 deliveries were vaginal deliveries, No history of ectopic pregnancy or STD.
At 1 ½ month, with BhCG of 7800, following findings were recorded

Figure 1: Empty uterus on 
sagittal plane

Figure 2: Empty uterus on transverse plane

Figure 3: Both ovaries normal.

Figure 4: Twin cervical ectopic pregnancy with cardiac activity 

Figure 5, 6: Gestational sac biometry of twin cervical ectopic.

Video 1:
 Twin cervical ectopic with cardiac activity & relation with uterine artery

Video 2: Magnified view of live twin cervical ectopic pregnancy

The risk was explained to the patient.
Baseline complete blood count & serum BhCG were repeated.
Injection of Methotraxate I/V 1 mg / Kg body weight was given twice alternate day  with prior antiemetic (Ondensetrone)
Sonography follow up was done – echogenicity of trophoblast reduced. Cardiac activity disappeared after 2 doses.
Serum BhCG after 1 week was done. Tab Mifepristone was given in a single dose.
Repeat BhCG at the end of week 2 was 79 units.
1 month later, it was less than 5 units.
Follow-up was observed for 23 days.
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