Illcrrtkrl*rrld 6 zyxwvutsrqponmlkjihgfed Y dk- International Journal of Gynecology & Obstetrics 46 (1994) 57-59 Case report Primary twin ovarian pregnancy R. Tuncer* a, T. Sipahi”, S. Erkaya”, N.K. Akar”, N.S. Bayqarb, S. Erqevik” zyxwvutsrqponmlk aDepartment of Obstetrics and Gynecology, ‘Department of Radiology. ‘Department of Pathology, Ziibeyde Hamm Maternity Hospital, Ankara, Turkey Received I April 1994; revision received I8 April 1994;accepted I8 April 1994 zyxwvutsrqponmlkjihgfedcbaZYXW Abstract A 20-year-old-woman, gravida II, para I, was admitted to the hospital with vaginal bleeding 17 weeks after her last menstrual period. Her pelvic examination was found to be compatible with 3.5 months of pregnancy by the attending physician. Ultrasonographic examination revealed an empty uterus and two dead fetuses with biometric data consistent with 14 weeks of pregnancy located in the left ovarian region. She was subjected to an explorative laparotomy and an intact gestational sac including the left ovary with normal tubes was observed; a unilateral salpingo-oophorectomy was carried out. Histologic studies confirmed a twin ovarian pregnancy. Although rare, ovarian pregnancy should be considered when approaching a case of ectopic pregnancy. Early diagnosis is generally based on ultrasonographic fin- dings. Advanced cases with unruptured sac and multiple gestations may also be present. Keywords: Ovarian pregnancy; Twin pregnancy 1. Introduction Primary ovarian pregnancy is an uncommon form of ectopic pregnancy constituting less than 3% of all cases [l-3]. Since the first report by St Maurice in 1682, numerous case reports as well as some series have appeared in the medical litera- ture, most of the recent ones concentrating on preoperative diagnosis to avoid an emergency situ- ation [1,4,5]. * Corresponding author, *hit Bahadlr Demir Sok. 13/l& 06570 Maltepe, Ankara, Turkey, Tel.: (312) 230 I6 76; Fax: (312) 31 I 63 72. In accordance with the increase in incidence of ectopic pregnancies, ovarian pregnancies seem to be on the increase possibly due to the use of in- trauterine devices, previous pelvic surgery, inflam- mation, and endometriosis [ 1,6,7]. However, after assisted reproduction, ovarian pregnancy seems to remain a rarity [8]. Furthermore, multiple ovarian gestations are extremely rare and only five cases of ovarian twin pregnancy have been previously reported [7]. A case of primary twin ovarian pregnancy is presented with the hope of increasing the estab- lishment of early preoperative diagnosis. 0020-7292/94/$07.00 0 1994 International Federation of Gynecology and Obstetrics SSDl 0020-7292(94)02135-L