Betti Marta, Vergani Patrizia, Damiani Gianluca Raffaello, Pellegrino Antonio, Di Naro Edoardo, Trojano Giuseppe, Pirovano Cecilia, Stomati Massimo, Loverro Matteo
Department of Obstetrics and Gynaecology, ASTT Lecco, Ospedale Alessandro Manzoni, Lecco, Italy.
Acta Biomed. 2018 Oct 8;89(3):423-427. doi: 10.23750/abm.v89i3.6915.
Unilateral twin tubal pregnancy is an extremely rare condition, occurring in 1/20.000-250.000 pregnancies and represents a major health risk for reproductive-aged women, leading to even life-threatening complications.
We present a case of a 31-year-old woman with unilateral twin tubal pregnancy, treated with methotrexate and then surgically because of failure, followed by review of the literature.
Researches for relevant data were conducted utilizing multiple databases, including PubMed and Ovid.
The most common type of twin ectopic pregnancy is the heterotopic (1/7000 pregnancies) in which in which both ectopic and intrauterine pregnancy occur simultaneously. Expectant, medical and surgical therapy have similar success rates in correctly selected patients. Two prospective randomized trials did not identify any statistically significant differences between groups receiving MTX as a single dose or in multiple doses. Among the 106 cases reported in literature, methotrexate was tried just in 4 patients (3 unilateral and 1 bilateral) before ours. Details are reported in the table 1.
The recent shift in the treatment of singleton ectopic pregnancies to the less invasive medical therapy might apply even in the case of twin implants.
单侧双输卵管妊娠是一种极为罕见的情况，发生率为1/20000 - 250000次妊娠，对育龄妇女构成重大健康风险，甚至会导致危及生命的并发症。
我们报告一例31岁单侧双输卵管妊娠的女性病例，先用甲氨蝶呤治疗，后因治疗失败进行手术治疗，并对相关文献进行回顾。
利用包括PubMed和Ovid在内的多个数据库检索相关数据。
双异位妊娠最常见的类型是异位同时妊娠（发生率为1/7000次妊娠），即异位妊娠和宫内妊娠同时发生。在正确选择的患者中，期待治疗、药物治疗和手术治疗的成功率相似。两项前瞻性随机试验未发现接受单剂量或多剂量甲氨蝶呤治疗的组间存在任何统计学上的显著差异。在文献报道的106例病例中，在我们之前只有4例患者（3例单侧和1例双侧）尝试使用过甲氨蝶呤。详情见表1。
近期单胎异位妊娠的治疗向侵入性较小的药物治疗转变，这甚至可能适用于双胎植入的情况。
