Abstract
Simultaneous bilateral tubal ectopic pregnancy is a rare entity. The reported incidence ranges between 1 in 725 to 1 in 1580 of all ectopic pregnancies, and it is higher in women undergoing assisted reproductive techniques or ovulation induction. Its spontaneous appearance is almost exceptional. There are no unique features in clinical presentation helping to distinguish it from unilateral ectopic pregnancy. This makes the pre-operative diagnosis difficult, so it’s commonly made during surgery. Whether the ectopic pregnancy is spontaneous or induced, fast management is essential and includes early diagnosis, detailed ultrasound scan, careful contralateral tube control, and also specimen’s histological verification. Thus the treatment will depend on the hemodynamic stability of the patient, the extent of tube damage, as well as the desire for future pregnancies. We report a case of 40 year old patient, gravida 1 without any ectopic pregnancy risk factors, who suffered from abdominal pain and vaginal bleeding at 8 gestation weeks. Endovaginal ultrasound detected adnexal ruptured mass in the right fallopian tube. Urgent laparotomy was performed for suspicious ruptured ectopic pregnancy. A right and left ruptured ectopic pregnancy were found during operation. Bilateral salpingectomy is done and patient is discharged from hospital 3 days later without complications.
Highlights
Bilateral ectopic pregnancy is a rare condition in which there are at least 2 concomitant pregnancies in the same patient, with both being located in opposite uterine appendages
The bilateral tubal ectopic pregnancy reported instance is 1 in 200 000 pregnancies, and more than half of those cases were the result of assisted reproductive technology (ART)
We report a case of spontaneous bilateral ruptured tubal ectopic pregnancy which was diagnosed during surgery
Summary
Bilateral ectopic pregnancy is a rare condition in which there are at least 2 concomitant pregnancies in the same patient, with both being located in opposite uterine appendages. The first case of primary bilateral ectopic pregnancy described was published by Bledsoe in 1918 [1]. The bilateral tubal ectopic pregnancy reported instance is 1 in 200 000 pregnancies, and more than half of those cases were the result of assisted reproductive technology (ART). The spontaneous form is exceptional and the first case was described in Colombia in 1997 [2]. The clinical presentation is unpredictable and its detection is urgent because of the associated morbidity and mortality due to the rupture. We report a case of spontaneous bilateral ruptured tubal ectopic pregnancy which was diagnosed during surgery
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