Ectopic pregnancy is a life-threatening condition affecting up to 2% of gestations. Implantation in the fallopian tube is most common, with symptoms typically presenting earlier for gestations in the ampulla and isthmus compared with the cornua and non-tubal sites. In this paper, the cases are described of two patients with advanced ectopic pregnancies that ruptured. One woman aged 36 years presented at 17 1/7 weeks' gestation with a ruptured cornual ectopic pregnancy. The other woman, aged 35 years, presented at 11 1/7′ weeks gestation with a ruptured ectopic pregnancy in the left tubal ampulla. To our knowledge, there are no other reported cases of a tubal ampulla pregnancy presenting at such an advanced gestation with no prior symptoms.

BackgroundGestational trophoblastic disease (GTD) is a rare developmental form of proliferative trophoblastic tissue. Sparse literature exists regarding the optimal management of patients with advanced GTD, but the definitive treatment is urgent surgical intervention.CaseA 48-year-old woman presented advanced GTD. She was medically managed for hypertension and hyperthyroidism prior to surgical intervention in order to minimize the risk of anesthetic and surgical complications.ConclusionAdvanced GTD is rare. Undetected GTD can result in complications such as thyrotoxicosis, which poses substantial risks in the peri-operative period. Appropriate identification and management of this clinical problem are essential to prevent complications as well as subsequent malignant sequelae.