A 29-year-old patient gravid 8, para 1 presented to rapid City OB/GYN for her new obstetrical appointment at 8 weeks of gestation. She had a history of recurrent miscarriage and had been attempting to conceive for 3 years. Past medical history was significant for polycystic ovarian syndrome, anovulation, and elevated testosterone. She also had a laparoscopic procedure in 2016 that revealed filmy adhesions consistent with prior Pelvic Inflammatory Disease (PID) and chlamydia, along with pelvic congestion syndrome and retrograde menstruation. Hysterosalpingogram at that time was negative.&nbsp;

High-resolution transvaginal ultrasound examination revealed an 8-week live twin gestation in the left fallopian tube, with the two foetal poles closely adjacent throughout the exam and likely conjoined. There was no twin peaking, with no chorion or amnion separating the two foetal poles. The uterus was empty. There was no fluid in the posterior cul de sac, and minimal fluid in the left adnexa (Figures 1-4). After counselling with the patient, she developed severe pelvic pain and was taken to surgery with the goal of maintaining her fertility while preventing the complications of tubal rupture and haemorrhage.

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MediSage Case Discussions

"Explore the case of a 29-year-old with twin ectopic pregnancy and recurrent miscarriage, focusing on diagnosis and surgical intervention."

"Managing Early Twin Gestation in Ectopic Pregnancy"

Pelvic pain

Clinical case discussion shared for educational purposes and professional medical opinion.