Abstract
Purpose of Investigation: Spontaneous bilateral tubal ectopic pregnancy (BTP) is the rarest form of ectopic pregnancy. Materials and Methods: A case of BTP diagnosed during surgery is reported and an algorithm has been proposed for the management of such patients. It is a case of a 32-year-old female at gestational age of nine weeks with spontaneous pregnancy reported vaginal bleeding. Results: The case describes the importance of identifying and examining both tubes at laparoscopy, despite the rarity of bilateral extra-uterine pregnancy. Emergency exploratory laparotomy revealed ruptured ectopic pregnancy along with active bleeding of the right tube (fimbrial region). The left tube was distended with a 3×4-cm mass at the fimbrial region. Conclusion: Bilateral conservative surgery is possible with unruptured ectopic tubal pregnancy.
Highlights
Spontaneous bilateral tubal pregnancies (BTP) without previous induction of ovulation are considered to be unusual
BTP is more often seen among the patients undergoing assisted reproductive techniques (ARTs)
It is important to be aware that this rare and potentially fatal condition can occur in patients, who do not represent any risk factors of BTP
Summary
Spontaneous bilateral tubal pregnancies (BTP) without previous induction of ovulation are considered to be unusual. The incidence of BTP has been reported from one in 725 to one in 1,580 ectopic pregnancies, one per 200,000 in normal pregnancies (live births), and five in one million deliveries [1-3]. BTP is considered to be the rarest form of ectopic pregnancy, which occurs spontaneously [1]. The diagnosis of BTP is critical because it is associated with morbidity and mortality. Most of the patients with BTPs have similar symptoms, signs, and risk factors to those with unilateral ectopic pregnancy. The main risk factors for ectopic pregnancy include multi-sexual partner, history of reproductive system infection, induced conception cycle, history of infertility, cigarette smoking, and intra-uterine device usage [4]
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