Sonographic Detection of Unruptured Dichorionic Unilateral Live Twin Ectopic Pregnancy

The incidence of twin ectopic pregnancy is about 1 in 125,000 spontaneous pregnancies. Live twin ectopic pregnancy is an exceptionally rare form of ectopic pregnancy. Currently, fewer than 10 cases have been reported with heartbeat demonstration in both embryos, whereas more than 100 cases of twin ectopic pregnancy have been reported. The author describes the transabdominal and transvaginal sonographic diagnosis of a unilateral live twin ectopic pregnancy. The patient presented with an eight-week amenorrhea history, complaints of right iliac fossa pain, and vaginal spotting. Sonography revealed two ectopic gestational sacs that were adjacent to each other, as well as an empty homogeneous uterus with smooth contour. Each embryo had a visible heartbeat and crown-rump length measuring 16 mm and 17 mm, respectively, which corresponded to a gestational age of eight weeks. The sacs measured 27 mm and 30 mm in diameter. No free fluid was seen in the Douglas cul-de-sac, suggesting an unruptured live twin ectopic pregnancy.