Abstract
IntroductionBilateral ectopic pregnancies are increasing due to an increase in the incidence of pelvic inflammatory disease and increase in assisted reproductive techniques. Spontaneous conception after bilateral ectopic pregnancies is extremely rare.Case presentationA 33-year-old Indian woman presented with ruptured ectopic pregnancy associated with hemoperitoneum for which she underwent a laparotomy. The diagnosis of bilateral ectopic pregnancies was made during surgery. Salpingectomy was done on one side and the other tube was conserved with salpingostomy. Six months after surgery, she conceived spontaneously and a transvaginal ultrasound examination revealed a 5-weeks live intrauterine pregnancy.ConclusionA meticulous surgical technique conserving one fallopian tube resulted in subsequent viable intrauterine pregnancy. The approach to such a case along with steps to minimize tubal damage is presented.
Highlights
Bilateral ectopic pregnancies are increasing due to an increase in the incidence of pelvic inflammatory disease and increase in assisted reproductive techniques
Spontaneous conception after bilateral tubal ectopic pregnancy is associated with an increased risk of recurrent ectopic pregnancy
Bilateral tubal ectopic pregnancy is the rarest form of ectopic pregnancy [2]
Summary
In the past few decades the incidence of unusual presentations of ectopic pregnancies has risen along with an increase in assisted reproductive techniques [1]. A pelvic examination revealed mild bleeding per vagina, a normal-sized uterus and left forniceal tenderness. With the clinical suspicion of ectopic pregnancy, an emergency ultrasound examination was performed which showed an empty normal-sized uterus and a gestational sac of 5×4cm with a fetal pole having cardiac activity in the left fallopian tube. Was distended at the ampullary region with a 3×3cm mass With these findings, a bilateral ampullary pregnancy with features of tubal abortion on the left fallopian tube was diagnosed (Figure 1). A linear salpingostomy was performed on her right fallopian tube after ligating the feeding vessel on the mesosalpinx 1cm below the ampullary ectopic pregnancy to control bleeding. The patient continued her pregnancy and eventually delivered a healthy baby at term
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