Bilateral Tubal Pregnancy without Known Risk Factor

Abstract

Spontaneous bilateral ectopic gestation is very rare. The authors report a case diagnosed and taken care of at Yalgado Ouedraogo Teaching Hospital, Ouagadougou. It was a 30-year-old patient with no known pathological history. She had presented at the obstetric emergencies with a state of hypovolemic shock by haemoperitoneum with digestive disorders, pelvic pain, vaginal bleeding, and a mention of delayed menstruation. The ultrasound coupled with the urinary immunological pregnancy test confirmed the diagnosis of ruptured ectopic pregnancy and a bilateral form was suspected. A laparotomy in emergency confirmed the diagnosis of bilateral ectopic gestation with a right ampullary unruptured pregnancy and a left isthmic ruptured gestation. A bilateral salpingectomy was performed and counseling was made for the use of medical help of procreation in case of future need of pregnancy.

A Rare Case of Bilateral Tubal Ectopic Pregnancy Following Intracytoplasmic Sperm Injection-Embryo Transfer (ICSI-ET)

“…Recent studies have showed that pelvic inflammatory disease and subsequent tubal occlusion have been described as risk factors for EP following both natural and assisted conception. 8,9 Deep fundal or rapid embryo transfer in tubal factor infertility patients may result in direct injection of transfer media into a dysfunctional fallopian tube. Poor embryo quality, as well as the use of multiple embryo transfer, is a risk factor for extrauterine implantation.…”

Multidose methotrexate treatment of cornual pregnancy after in vitro fertilization: Two case reports

“…On day 3, blood results were as follows: WBC 4.150/μL, Hb 14.2 g/dL, β-hCG 4.165 IU/L. According to the hospital guidelines [ [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] ], since β-hCG serum levels had not declined by more than 15%, the treatment continued in the same way. The patient received three more doses of MTX 100 mg on days 3, 5 and 7 and every dose was followed by administration of folinic acid 10 mg, on days 4, 6 and 8.…”

“…Risk factors include history of ipsilateral salpingectomy, a previous ectopic pregnancy, pelvic inflammatory disease and use of assisted reproductive techniques (ART) [ 7 , 8 ]. However, no risk factors are present in 50% of all women diagnosed with a cornual pregnancy [ 9 ]. The symptoms of a cornual pregnancy appear later compared to an ectopic pregnancy, leading to higher probability of rupture [ 10 ].…”

A case of bilateral tubal ectopic pregnancy following intrauterine insemination

“…The decision for the management of EP should be based on different factors which include the pregnancy location, the status of fallopian tube during the diagnosis and finally the consequences of the treatment onto future pregnancies 3,9 . The treatment of the BTP was challenging in our case as the patient had IUI for primary infertility.…”

“…The available options were right salpingostomy, right salpingectomy or methotrexate (MTX) administration alone or with right salpingostomy. Occasionally, salpingostomy itself could be preferred to salpingectomy for fertility conservation; however this could lead to recurrence of EP as well as the continuity of trophoblastic disease in cases of molar pregnancy 9 . Bilateral salpingectomy is considered a good choice if the patient is counselled and willing for other ART such as ICSI or IVF-ET 3 .…”