Simultaneous bilateral fallopian tubal pregnancy of a laparoscopic definite spontaneous unilateral ovulation: a case report

Zhen-Zhen Wang,Li Zhao,Er-Kai Yu,Lian-Wei Xu,Hui-Cong Liu,Yi-Jia Chen

doi:10.1186/s12884-022-04453-0

Abstract

BackgroundBilateral simultaneous fallopian tubal pregnancy is one of the rarest forms of ectopic pregnancy. Due to the lack of unique features and clinical presentation to distinguish bilateral from unilateral ectopic pregnancy, challenges the diagnosis.Case reportA 27-year-old Asian woman presented with pelvic pain and vaginal bleeding. Pelvic transvaginal ultrasound showed fluid in Douglas Pouch and posterior fornix puncture revealed unclotted blood. Laparoscopic examination unveiled bilateral ectopic pregnancy with two corpus luteum visible in the right ovary, suggesting a double spontaneous unilateral ovulation. Bilateral fallopian tube fenestration and embryo extraction were performed to preserve fertility.ConclusionDiagnosis of bilateral tubal pregnancy is difficult during preoperative ultrasound examination and careful examination during laparoscopic inspection of the whole pelvic cavity to avoid missed diagnosis.

Highlights

Bilateral simultaneous fallopian tubal pregnancy is one of the rarest forms of ectopic pregnancy
Ectopic pregnancy, one of the most frequently encountered acute abdominal diseases in gynecology and obstetrics, has an incidence of 1% and a growing prevalence [1]. It is the major cause of maternal death, during the first trimester [1]
While unilateral tubal ectopic pregnancy is commonly seen, bilateral simultaneous fallopian tubal pregnancy is rare with a reported incidence of 5 in 1 million deliveries and showed a higher incidence among patients with a history of Assisted Reproductive Techniques (ARTs) utilization or following ovulation induction [1, 3, 4]

Summary

Conclusion

Diagnosis of bilateral tubal pregnancy is difficult during preoperative ultrasound examination and care‐ ful examination during laparoscopic inspection of the whole pelvic cavity to avoid missed diagnosis.

Background

Findings

Discussion and conclusion