Bilateral Tubal Ectopic Pregnancy

A report describes a case of a 31 years old female with a history of 2 previous pregnancies, one cesarean delivery, and one abortion, who was spontaneously pregnant with an estimated gestational age of 6 weeks and four days, as calculated by the last menstrual period, was admitted to the hospital with complaints of intense pain in the hypogastrium and right lower quadrant. She denied any episode of bleeding, fever, or urinary symptoms and had no history of sexually transmitted infections. 

Physical examination of the abdomen did not allow palpation of the uterus and revealed painful decompression of the right lower quadrant. The pelvic examination showed a closed uterine cervix, not painful at mobilization. Initial blood workup: β-hCG was 4800 mUI/mL; reactive C-Protein was 3,9 units; Hemoglobin was 11,4 units; urinalysis and urine Gram staining were unremarkable. 

Transvaginal ultrasound revealed a para-ovarian mass in the right adnexal region with an estimated volume of 8,8 cm3 and no free fluid in the pelvic cavity. She underwent exploratory laparotomy, which revealed blood upon opening of the abdomen and adnexal masses in both fallopian tubes upon exploring the cavity, ruptured on the left and whole on the right. The physicians performed bilateral salpingectomy and sent the material for anatomopathological analysis. Microscopy revealed parietal and intraluminal hemorrhage in both tubes, as well as chorionic villi intermingled and, ultimately, bilateral ectopic pregnancy.

Valadão CED, de Melob CSB, Brandão LV, Tofanic GB. Spontaneous Bilateral Tubal Ectopic Pregnancy: Case Report and Literature Review. Int J Gynecol Clin Pract. 2023; 10: 165. https://doi.org/10.15344/2394-4986/2023/165