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This section is suitable for reporting cases, results of therapeutic trials, and descriptions of new procedures or instruments. Reports should be limited to seven hundred words and two references. Use of an illustration or table requires a proportionate reduction in total words.
Unilateral tubal twin gestation MARC ROY
medial portion of the right Fallopian tube was markedly dilated and hemorrhagic. A right salpingo-oophorectomy was done. In the midportion of the Fallopian tube, there was a hemorrhagic area which measured 6.0 by 6.5 by 2.5 cm. Upon cutting of the specimen, one amniotic sac was noted. This sac contained two embryos each measuring 1.5 cm. in length. No abnormalities were noted grossly or microscopically.
P. STORCH H.
PETRIE
Depatiments of Pathology and Obstetrics and Gynecology, Columbia-Presbyterian Medical Center, Neur York, New York
Although there have been two reports of dizygotic unilateral tubal twin gestation, it is generally accepted that most cases of unilateral tubal twin gestation have been monozygotic as evidenced by the close correlation of size and developmental stage’of the embryos. The case just reported appears to uphold this idea. The etiologies of tubal multiple gestation appear t.o be the same as those encountered in singular tubal gestation. These include tubal damage or anatomic alteration from pelvic inflammatory disease, congenitai abnormalities, tumors, and surgical intervention. A strong family history for twins is not always found, although the patient in the case just presented had had stillborn twins. The preoperative diagnosis of unilateral multiple gestation is exceedingly difficult to make. A history suggestive of possible multiple gestation with an adnexal mass disproportionately large compared to the duration of amenorrhea is at best indicative and is in no way diagnostic of unilateral multiple gestation. It is our belief that this case of unilateral tubal tvkin gestation represents the eighty-seventh authentically reported case in the English language journals.
UNILATERAL TUBAL multiple gestation is exceedingly rare as evidenced by the fact that the last authentically reported case was in 1969.’ Since the first reported case by de Ott* in 1891, a number of cases of multiple gestation occurring in one tube have been reported. The most common form of a multiple gestation involving a tube is the combined extrauterine (tubal) and intrauterine gestation. A unilateral twin gestation is more common than bilateral twin tubal gestation. Even more rare is a unilateral tubal triplet gestation followed by an interstitial twin gestation. A single case of a quintuplet tubal gestation has been reported. Mrs. J. G., a 34-year-old Negro, gravida 3, para 2, was admitted to the Columbia-Presbyterian Medical Center on March 19, 1975, with irregular vaginal bleeding and pelvic pain. The last menstrual period was December 29, 1974. She had excessive intermittent vaginal spotting since that time. Dilatation and curettage were performed with subsequent microscopic examination revealing decidual reaction. The patient was carefully followed in the outpatient department. She had no pain or vaginal bleeding until April 2, 1975, when she developed lower abdominal pain for which she was readmitted. Pelvic examination revealed a 6 cm. tender right adnexal mass. The vital signs were completely stable. An exploratory laparotomy was performed, and approximately 150 ml. of dark blood was noted in the peritoneal cavity. The
REFERENCES
1. Weekes, L. R., DeFrancisco, J. C., and Miller, W.: Unilateral tubal twin pregnancy, AM. J. OBSTET. GYNECOL. 103: 1172, 1969. 2. de Ott, D.: A case of unilateral tubal twin gestation, Ann. Gynecol. Obstet. 36: 304, 1891.
Reprint requests: Dr. Marc P. Starch, Department of Obstetrics and Gynecology, North Shore University Hospital-Cornell University Medical College, Manhasset, New York 11030.
1148
This section is suitable for reporting cases, results of therapeutic trials, and descriptions of new procedures or instruments. Reports should be limited to seven hundred words and two references. Use of an illustration or table requires a proportionate reduction in total words.
Unilateral tubal twin gestation MARC ROY
medial portion of the right Fallopian tube was markedly dilated and hemorrhagic. A right salpingo-oophorectomy was done. In the midportion of the Fallopian tube, there was a hemorrhagic area which measured 6.0 by 6.5 by 2.5 cm. Upon cutting of the specimen, one amniotic sac was noted. This sac contained two embryos each measuring 1.5 cm. in length. No abnormalities were noted grossly or microscopically.
P. STORCH H.
PETRIE
Depatiments of Pathology and Obstetrics and Gynecology, Columbia-Presbyterian Medical Center, Neur York, New York
Although there have been two reports of dizygotic unilateral tubal twin gestation, it is generally accepted that most cases of unilateral tubal twin gestation have been monozygotic as evidenced by the close correlation of size and developmental stage’of the embryos. The case just reported appears to uphold this idea. The etiologies of tubal multiple gestation appear t.o be the same as those encountered in singular tubal gestation. These include tubal damage or anatomic alteration from pelvic inflammatory disease, congenitai abnormalities, tumors, and surgical intervention. A strong family history for twins is not always found, although the patient in the case just presented had had stillborn twins. The preoperative diagnosis of unilateral multiple gestation is exceedingly difficult to make. A history suggestive of possible multiple gestation with an adnexal mass disproportionately large compared to the duration of amenorrhea is at best indicative and is in no way diagnostic of unilateral multiple gestation. It is our belief that this case of unilateral tubal tvkin gestation represents the eighty-seventh authentically reported case in the English language journals.
UNILATERAL TUBAL multiple gestation is exceedingly rare as evidenced by the fact that the last authentically reported case was in 1969.’ Since the first reported case by de Ott* in 1891, a number of cases of multiple gestation occurring in one tube have been reported. The most common form of a multiple gestation involving a tube is the combined extrauterine (tubal) and intrauterine gestation. A unilateral twin gestation is more common than bilateral twin tubal gestation. Even more rare is a unilateral tubal triplet gestation followed by an interstitial twin gestation. A single case of a quintuplet tubal gestation has been reported. Mrs. J. G., a 34-year-old Negro, gravida 3, para 2, was admitted to the Columbia-Presbyterian Medical Center on March 19, 1975, with irregular vaginal bleeding and pelvic pain. The last menstrual period was December 29, 1974. She had excessive intermittent vaginal spotting since that time. Dilatation and curettage were performed with subsequent microscopic examination revealing decidual reaction. The patient was carefully followed in the outpatient department. She had no pain or vaginal bleeding until April 2, 1975, when she developed lower abdominal pain for which she was readmitted. Pelvic examination revealed a 6 cm. tender right adnexal mass. The vital signs were completely stable. An exploratory laparotomy was performed, and approximately 150 ml. of dark blood was noted in the peritoneal cavity. The
REFERENCES
1. Weekes, L. R., DeFrancisco, J. C., and Miller, W.: Unilateral tubal twin pregnancy, AM. J. OBSTET. GYNECOL. 103: 1172, 1969. 2. de Ott, D.: A case of unilateral tubal twin gestation, Ann. Gynecol. Obstet. 36: 304, 1891.
Reprint requests: Dr. Marc P. Starch, Department of Obstetrics and Gynecology, North Shore University Hospital-Cornell University Medical College, Manhasset, New York 11030.
1148
