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Case Report
Vanishing twin syndrome and chronic ruptured ectopic pregnancy in the setting of triplet heterotopic pregnancy
1 Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, USA
2 Texas A&M Medical School, College Station, TX, USA
Address correspondence to:
Wahibah Hannan
1401 St. Joseph Parkway, 2SKS, Houston, TX 77002,
USA
Message to Corresponding Author
Article ID: 100200Z08QR2025
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Rhodes Q, Hannan W, Gondokusumo J, Hoopes S. Vanishing twin syndrome and chronic ruptured ectopic pregnancy in the setting of triplet heterotopic pregnancy. J Case Rep Images Obstet Gynecol 2025;11(1):58–63.ABSTRACT
Introduction: The objective of this article is to present a case of a concurrent chronic ruptured ectopic pregnancy (CEP) and vanishing twin syndrome (VTS) in the setting of a naturally conceived heterotopic triplet pregnancy.
Case Report: A 31-year-old multiparous female presented with abdominal pain, vaginal bleeding, VTS, and an indeterminate mass in the posterior cul-de-sac. The diagnosis of a rare triplet heterotopic pregnancy (HP) was made during laparoscopy in the setting of VTS and CEP. The patient underwent laparoscopic left salpingectomy, and the remaining viable intrauterine pregnancy progressed to term vaginal delivery.
Conclusion: This case highlights the danger of relying on probability to rule out medical diagnoses and brevity of medical literature on CEP. Two intrauterine gestational sacs delayed arrival at the correct diagnosis of ectopic pregnancy due to the rarity of HP. In addition, providers did not recognize the classic signs of CEP: prolonged intermittent pelvic pain, vaginal bleeding, and an amorphous, avascular pelvic mass. Additional information regarding CEP should be included in common medical educational resources to better inform patient care.
Keywords: Chronic ruptured ectopic pregnancy, Heterotopic triplet pregnancy, Vanishing twin syndrome
SUPPORTING INFORMATION
Author Contributions
Quinn Rhodes - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Wahibah Hannan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Jabez Gondokusumo - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sarah Hoopes - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Quinn Rhodes et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
