RESUMO
A 24 years Muslim lady was admitted to SSKM Hospital with the complaint of pain lower abdomen, more on left side with ultrasonography diagnosis of alive foetuses in a twin pregnancy of 19-20 weeks of gestational age. On the very next day, foetal heart sound disappeared with complaint of no foetal movement. Doppler study and USG confirmed death of the foetuses. Laparotomy performed 3 weeks after foetal death revealed soft bulky uterus of about 10 weeks gestational age. Left fallopian tube was found highly stretched over the upper aspect of gestational mass and left overy could not be traced. Total hysterectomy with removal of the mass and left tube with preservation of right ovary and tube was carried out. On pathological examination, the uterus and the gestational mass were found empty and separated from the mass. There were two gestational sacs with two separate placentae, cords and foetuses of 20 weeks maturity. Microscopic examination showed infiltration of ovarian stroma by intermediate trophoblast indicating ovarian nidation.