Twin pregnancy, one in the uterus, one outside the uterus

Quang Ninh 36 year old pregnant woman, severe abdominal pain, doctor discovered carrying twins, one in the uterus, one outside the uterus.

On September 23, a representative of the Tien Yen District Medical Center said that the patient was pregnant with twins through artificial insemination (IVF), had two embryos transferred into the uterus, and then suddenly had abdominal pain. 13 years ago, she had a history of open surgery for an ectopic pregnancy.

The ultrasound results showed that the two fetuses were in two different positions. One fetus was located inside the uterus and developing normally. The other fetus was outside the uterus, developing at the right fallopian tube isthmus, and had signs of rupture.

The team of doctors consulted and performed emergency laparoscopic surgery to remove the ectopic pregnancy from the patient. The doctors chose the most appropriate anesthesia method to ensure the surgery was safe, to minimize side effects on the fetus developing in the uterus. The surgical team cleaned the abdominal cavity, minimizing contact with the uterus, and protecting the fetus.

Currently the pregnant woman is awake, the remaining fetus is developing normally.

Doctor examines patient. Photo: Provided by hospital — Doctor examines patient. Photo: *Provided by hospital*

Doctor Le Thu Hoai said that simultaneous twin pregnancy, one ectopic pregnancy and one intrauterine pregnancy, is rare. According to world medical literature, this condition accounts for 1/30,000 cases of natural pregnancy. In vitro fertilization, the rate of abnormal twins is higher. The location of ectopic and intrauterine twins is often in the cervix, ovaries, fallopian tubes, and cesarean section scar area.

If ectopic pregnancy is detected late and not treated promptly, it can lead to complications such as rupture, massive bleeding, and threaten the health of both mother and fetus. This is the leading cause of death among obstetric complications in the first three months of pregnancy. However, this condition can be easily detected by ultrasound.

Therefore, doctors recommend that women of reproductive age should see a doctor immediately when abnormal signs appear such as amenorrhea, delayed menstruation for a few days or menstrual disorders, possibly signs of morning sickness, breast tenderness, lower abdominal pain, dark brown bleeding sometimes mixed with membrane, not clotting...

Thuy Quynh

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