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Spontaneous and Simultaneous Bilateral Ruptured Tubal Ectopic Pregnancy: A Case Report

Received: 1 October 2020     Accepted: 13 November 2020     Published: 15 January 2021
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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.

Published in Journal of Gynecology and Obstetrics (Volume 9, Issue 1)
DOI 10.11648/j.jgo.20210901.11
Page(s) 1-4
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Ectopic Pregnancy, Ruptured Fallopian Tube, Bilateral Salpingectomy

References
[1] José F. De Los Ríos, MD, Juan D. Castañeda, MD, and Aguirre Miryam, MD Bilateral ectopic pregnancy.
[2] De Los Ríos JF (2006), Castañeda JD, Restrepo E. Lineal laparoscopic salpingostomy for treating spontaneous bilateral ectopic pregnancy: a case report. Rev Colomb Obstet Ginecol.
[3] Eze J N (2012), Obuna J A, Ejikeme B N. Bilateral tubal ectopic pregnancies: a report of two cases. Ann Afr Med.
[4] Tabachnikoff R M, Dada M O, Woods R J. et al. Bilateral tubal pregnancy. A report of an unusual case. J Reprod Med.
[5] Foster H M (1982), Lakshin A S, Taylor W F. Bilateral tubal pregnancy with vaginal delivery. Obstet Gynecol.
[6] Baijal N (2007), Sahni M, Verma N. et al. Discordant twins with the smaller baby appropriate for gestational age–unusual manifestation of superfetation: a case report. BMC Pediatre.
[7] Fishback HR (1939). Bilateral simultaneous tubal pregnancy. Am J Obstet Gynecol.
[8] Norris S (1953). Bilateral simultaneous tubal pregnancy. Can Med Assoc J.
[9] Barnhart K T (2006), Sammel M D, Gracia C R. et al. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertil Steril.
[10] G. A. Al-Quraan (2007), M. I. Al6Taani, B. M. Nusair, A. El-Masri, M. R. Arafat and M. M. Khateeb Spontaneous ruptured and intact bilateral tubal ectopic pregnancy.
[11] Marpeau O (2005), Barranger E, Cortez A, Uzan S. Bilateral tubal pregnancy after natural conception: a case report. J Reprod Med.
[12] Frates M C (2014), Doubilet P M, Peters H E. et al. Adnexal sonographic findings in ectopic pregnancy and their correlation with tubal rupture and human chorionic gonadotropin levels. J Ultrasound Med.
[13] Denise Niza (2017) Benardete Harari, Diego Meraz Ávila, Rolando Álvarez Valero, Fátima Rubio Tijerina Embarazo ectópico tubárico bilateral espontáneo.
[14] Wang M (2014), Chen B, Wang J. et al. Nonsurgical management of live tubal ectopic pregnancy by ultrasound-guided local injection and systemic methotrexate. J Minim Invasive Gynecol.
[15] Krissi H (2014), Hiersch L, Stolovitch N. et al. Outcome, complications and future fertility in women treated with uterine artery embolization and methotrexate for non-tubal ectopic pregnancy. Eur J Obstet Gynecol Reprod Biol.
[16] Saubhagya Kumar Jena (2016), Sweta Singh, Monalisha Nayak, Leena Das, and Swagatika Senapati Pregnancy: A Case Report, Review of Literature and a Proposed Management Algorithm.
[17] Mol F (2014), van Mello N M, Strandell A. European Surgery in Ectopic Pregnancy (ESEP) study group. Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial. Lancet.
[18] S. Hoffmann (2016), H. Abele, and C. Bachmann Spontaneous Bilateral Tubal Ectopic Pregnancy: Incidental Finding during Laparoscopy- Brief report and Review of Literature.
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  • APA Style

    Zidane Farah, Cherkaoui Malki Nivine, Sebti Mamoun, Yousfi Mounia, Bargach Samir. (2021). Spontaneous and Simultaneous Bilateral Ruptured Tubal Ectopic Pregnancy: A Case Report. Journal of Gynecology and Obstetrics, 9(1), 1-4. https://doi.org/10.11648/j.jgo.20210901.11

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    ACS Style

    Zidane Farah; Cherkaoui Malki Nivine; Sebti Mamoun; Yousfi Mounia; Bargach Samir. Spontaneous and Simultaneous Bilateral Ruptured Tubal Ectopic Pregnancy: A Case Report. J. Gynecol. Obstet. 2021, 9(1), 1-4. doi: 10.11648/j.jgo.20210901.11

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    AMA Style

    Zidane Farah, Cherkaoui Malki Nivine, Sebti Mamoun, Yousfi Mounia, Bargach Samir. Spontaneous and Simultaneous Bilateral Ruptured Tubal Ectopic Pregnancy: A Case Report. J Gynecol Obstet. 2021;9(1):1-4. doi: 10.11648/j.jgo.20210901.11

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  • @article{10.11648/j.jgo.20210901.11,
      author = {Zidane Farah and Cherkaoui Malki Nivine and Sebti Mamoun and Yousfi Mounia and Bargach Samir},
      title = {Spontaneous and Simultaneous Bilateral Ruptured Tubal Ectopic Pregnancy: A Case Report},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {9},
      number = {1},
      pages = {1-4},
      doi = {10.11648/j.jgo.20210901.11},
      url = {https://doi.org/10.11648/j.jgo.20210901.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20210901.11},
      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.},
     year = {2021}
    }
    

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    AB  - 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.
    VL  - 9
    IS  - 1
    ER  - 

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Author Information
  • Department of Obstetrics and Gynecology, Maternity Souissi Ibn Sina, University Mohammed V, Rabat, Morocco

  • Department of Obstetrics and Gynecology, Maternity Souissi Ibn Sina, University Mohammed V, Rabat, Morocco

  • Department of Obstetrics and Gynecology, Maternity Souissi Ibn Sina, University Mohammed V, Rabat, Morocco

  • Department of Obstetrics and Gynecology, Maternity Souissi Ibn Sina, University Mohammed V, Rabat, Morocco

  • Department of Obstetrics and Gynecology, Maternity Souissi Ibn Sina, University Mohammed V, Rabat, Morocco

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