Abstract：
To report a peculiar case of ultrasound diagnosis of spontaneous angular twin pregnancy. In literature, the terms \"angular,\" \"interstitial,\" and \"cornual\" pregnancies are often used inappropriately. Confusion in terminology may have contributed to difficulties in developing diagnostic ultrasound criteria to differentiate these ectopic pregnancies.
Case report.
Obstetrics and Gynecology, Community Hospital \"S. Maria delle Croci.\"
A 28-year-old patient with a previous cesarean delivery was admitted to our hospital for management of a presumed angular ectopic pregnancy. Transvaginal ultrasound confirmed an ectopic dichorionic diamniotic twin pregnancy eccentrically located in the right superior angle of the uterine cavity: the first gestational sac appeared to have right angular implantation, whereas the second gestational sac seemed to deepen inside the myometrium, with a thin myometrial margin of only 3 mm.
After discussing the risks, the patient requested to proceed with termination. A single intramuscular injection of 75 mg of methotrexate was administered, followed by ultrasound-guided hysterosuction after 19 days due to severe vaginal bleeding.
An early and accurate ultrasound diagnosis of a high-risk condition allowed for conservative medical treatment.
The serum beta-human chorionic gonadotropin levels progressively decreased. After 1 month, a clinical and ultrasound examination showed a regular endometrial line with a regular reappearance of menstrual bleeding.
Although there are remarkable advances in ultrasound techniques, angular pregnancy remains a condition of difficult diagnosis and management; it is potentially dangerous and may lead to severe complications. An early and accurate diagnosis of this condition is necessary to avoid complications and individualize the subsequent management.
Case report.
Obstetrics and Gynecology, Community Hospital \"S. Maria delle Croci.\"
A 28-year-old patient with a previous cesarean delivery was admitted to our hospital for management of a presumed angular ectopic pregnancy. Transvaginal ultrasound confirmed an ectopic dichorionic diamniotic twin pregnancy eccentrically located in the right superior angle of the uterine cavity: the first gestational sac appeared to have right angular implantation, whereas the second gestational sac seemed to deepen inside the myometrium, with a thin myometrial margin of only 3 mm.
After discussing the risks, the patient requested to proceed with termination. A single intramuscular injection of 75 mg of methotrexate was administered, followed by ultrasound-guided hysterosuction after 19 days due to severe vaginal bleeding.
An early and accurate ultrasound diagnosis of a high-risk condition allowed for conservative medical treatment.
The serum beta-human chorionic gonadotropin levels progressively decreased. After 1 month, a clinical and ultrasound examination showed a regular endometrial line with a regular reappearance of menstrual bleeding.
Although there are remarkable advances in ultrasound techniques, angular pregnancy remains a condition of difficult diagnosis and management; it is potentially dangerous and may lead to severe complications. An early and accurate diagnosis of this condition is necessary to avoid complications and individualize the subsequent management.
摘要：
报告1例超声诊断自发性双胎角状妊娠的特殊病例。在文学中,术语“角度”，\"\"插页,“”和“宫角”怀孕经常被不适当地使用。术语的混乱可能导致难以制定诊断超声标准以区分这些异位妊娠。
病例报告。
妇产科，社区医院MariadelleCroci.\"
一名28岁的既往剖腹产患者因推测角状异位妊娠而入院治疗。经阴道超声证实异位双胎双胎妊娠位于子宫腔右上角：第一个孕囊似乎有直角植入，而第二个妊娠囊似乎在子宫肌层内部加深，只有3毫米的子宫肌层边缘薄。
在讨论了风险之后，患者要求继续终止。单次肌肉注射75毫克甲氨蝶呤，由于严重的阴道出血，在19天后进行超声引导下的宫腔抽吸。
对高风险疾病的早期准确超声诊断可以进行保守治疗。
血清β-人绒毛膜促性腺激素水平逐渐降低。一个月后,临床和超声检查显示子宫内膜有规律，月经出血有规律再现。
虽然超声技术有了显著的进步,角度妊娠仍然是诊断和管理困难的条件;它是潜在的危险，并可能导致严重的并发症。必须对这种情况进行早期和准确的诊断，以避免并发症并个性化后续管理。
病例报告。
妇产科，社区医院MariadelleCroci.\"
一名28岁的既往剖腹产患者因推测角状异位妊娠而入院治疗。经阴道超声证实异位双胎双胎妊娠位于子宫腔右上角：第一个孕囊似乎有直角植入，而第二个妊娠囊似乎在子宫肌层内部加深，只有3毫米的子宫肌层边缘薄。
在讨论了风险之后，患者要求继续终止。单次肌肉注射75毫克甲氨蝶呤，由于严重的阴道出血，在19天后进行超声引导下的宫腔抽吸。
对高风险疾病的早期准确超声诊断可以进行保守治疗。
血清β-人绒毛膜促性腺激素水平逐渐降低。一个月后,临床和超声检查显示子宫内膜有规律，月经出血有规律再现。
虽然超声技术有了显著的进步,角度妊娠仍然是诊断和管理困难的条件;它是潜在的危险，并可能导致严重的并发症。必须对这种情况进行早期和准确的诊断，以避免并发症并个性化后续管理。
