Lessons from a case of tubal twin pregnancy

Ogeng’o J. "Lessons from a case of tubal twin pregnancy." Anatomy Journal of Africa.. 2017;6(1):817-819.


Unilateral tubal twin pregnancy illustrates and amplifies fundamental phenomena in developmental and
reproductive anatomy. Knowledge of this condition is also important to practicing obstetricians and
gynaecologists because it may constitute a diagnostic challenge, management dilemma, complex ethical
issues and increased risk for maternal morbidity and mortality (Benn et al., 2016). Previously considered
a rare occurence, recent data suggest that the condition is not uncommon (Svirsky et al., 2010). Indeed,
there are many reports (Vohra et al., 2014), including several from Sub-Saharan Africa (Makinde and
Ogunniyi, 1990). The case reported by Pulei et al., in Anat J Afr 2017; 6 (1) reveals several unique
features in the profile of risk factors, location, chorionicity and amnionicity, mode and time of
presentation, condition of the tube, diagnosis and fetal viability. There was no evidence of the
conventional risk factors (Sivalingam et al., 2011). This is consistent with several other reported cases
where it occurred spontaneously (Abi Khalil et al., 2016). In the present case, however, the patient had
multiple intramural and subserosal leiomyomata. Intramural myomata are known to disrupt uterine
contractility which may interfere with transport of the ovum and hence predispose to ectopic pregnancy
(Ajibade et al., 2012). It is probable, therefore, that this was the predisposing factor. Accordingly, it may
be useful to monitor patients with uterine fibroids for potential to suffer ectopic pregnancy. Family
history of twinning may have been useful, and is advocated, in view of the fact that it is one of the major
predisposing factors.

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