Rare intrauterine pregnancy combined with ectopic pregnancy

Pepe is very enviable because she has a pair of lovely twins, a boy and a girl. But recently, she was hospitalized. I went to visit her and found out what happened.

I had missed my period for 38 days, and I was experiencing nausea, vomiting, and other early pregnancy symptoms. I checked my urine for HCG and it showed positive, but I already had a pair of twins and didn't want to have any more, so I had to give up the baby with great pain. So I took "Xiyin" for abortion on August 1, 2012, and took "Misoprodol" in the morning on the 4th day (August 4, 2012). At around 7 o'clock that night, there were many people going out, so I did a forceps curettage to scrape out embryonic tissue about 70 days old, and the head, hands, feet and placenta were visible. On August 5, 2012, there was still a lot of bleeding, and considering that the curettage was incomplete, I did a second curettage to scrape out a small amount of decidual tissue, and the vaginal bleeding decreased, but it was still dripping. On August 12, 2012, I suddenly felt dizzy and nauseous, and vomited a little stomach contents, and had severe pain in my lower abdomen, so I went to the hospital. Physical examination: pale complexion, painful expression, obvious tenderness in the lower abdomen, and shifting dullness; gynecological examination: obvious cervical lifting tenderness, soft uterus, unclear contour, obvious tenderness, fullness of the right adnexal area, hemorrhagic fluid in the posterior fornix puncture, and non-coagulated blood in the abdominal cavity; B-ultrasound showed a liquid dark area and a large amount of fluid accumulation in the left adnexal area. Considering ectopic pregnancy, an emergency laparotomy was performed. During the operation, about 1200ml of blood in the abdominal cavity was removed. The left fallopian tube fimbria was enlarged and there was active bleeding. Strict hemostasis was performed after resection. Pathological examination showed that the villous tissue invaded the muscular layer.

Twin pregnancy is not uncommon, but it is rare for one fetus to be intrauterine and the other to be ectopic (fallopian tube pregnancy). Two mature fertilized eggs are fertilized at the same time, one fertilized egg implants and develops in the uterine cavity, while the other stays in the fallopian tube to implant and develop, forming an ectopic pregnancy.