Successful Laparoscopic Diagnosis and Management of Bilateral Tubal Pregnancy: Description of a Case and Review of the Literature

Abstract

Background: Bilateral tubal pregnancy is extremely rare, but, today, the incidence has increased because of the common use of ovarian stimulation and in vitro fertilization (IVF). This article reports a case of a contralateral small tubal pregnancy together with a ruptured tubal pregnancy and describes how laparoscopy assisted in this diagnosis. Case: A 28-year-old woman presented with vaginal bleeding and right-sided abdominal pain. She had undergone IVF and transfer of 2 embryos 4 weeks prior. Her serum β-human chorionic gonadotropin (β-hCG) level was 12,889 mIU/mL. Results: A diagnostic laparoscopy was performed. The patient was diagnosed with a ruptured right tubal pregnancy and a salpingectomy was performed. In addition, a small distension of the left tube was found and a left salpingectomy was performed. Pathologic examination identified chorionic villi in both fallopian tubes. The patient's postoperative course was uneventful. Conclusions: This case report highlights that clinicians need to be aware of such rare and potentially fatal conditions after IVF, and that repeated transvaginal ultrasound and hCG assays are mandatory.