Ectopic twin pregnancy in cesarean scar after in vitro fertilization/embryo transfer: case report.

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.