Bilateral Simultaneous Tubal Ectopic Pregnancy: A Case Report, Review of Literature and a Proposed Management Algorithm

Jena, Saubhagya Kumar; Singh, Sweta; Nayak, M. M.; Das, Leena; Senapati, Swagatika

doi:10.7860/jcdr/2016/16521.7416

Cited by 19 publications

(44 citation statements)

References 7 publications

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“…Some cases thought to be spontaneous have revealed intraoperative signs of concealed ovarian induction [5]. Risk factors for spontaneous BEPs are similar to those for unilateral EPs and there are no established differences in their clinical presentation [5, 16]. …”

Section: Discussionmentioning

confidence: 99%

“…Bilateral tubal ectopic pregnancies (BEPs) are a very rare form of ectopic pregnancy [5], and incidence has been reported as 1 in 725 to 1 in 1580 of ectopic pregnancies equating to approximately 1 in 200,000 pregnancies [6]. …”

Section: Introductionmentioning

confidence: 99%

“…The majority of cases are diagnosed intraoperatively; traditional diagnostic methods such as serial beta-human chorionic gonadotrophin levels (beta-hCG) or transvaginal ultrasound have shown poor efficacy when applied to BEPs [5]. Management is typically with bilateral salpingectomy.…”

Section: Introductionmentioning

confidence: 99%

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Unilateral Atraumatic Expulsion of an Ectopic Pregnancy in a Case of Bilateral Ectopic Pregnancy

Sampson

Mogekwu

Ahmed

et al. 2017

Case Reports in Obstetrics and Gynecology

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Ectopic pregnancy occurs in 1-2% of pregnancies. The fallopian tube is the most common site; however, bilateral tubal ectopic pregnancy is an extremely rare phenomenon, seen in approximately 1/200,000 pregnancies. It is usually the result of assisted reproductive techniques (ART). Ultrasound (USS) and serial beta-hCG levels have shown poor efficacy for accurate diagnosis. Laparoscopy is the diagnostic gold standard. The majority of cases are managed surgically with bilateral salpingectomy. A 26-year-old female presented to our early pregnancy unit with pain and vaginal bleeding at 5-week gestation after IVF. USS was inconclusive and her b-hCG levels rose with worsening pain; therefore, a decision was made for diagnostic laparoscopy. Although there was a clear right sided ectopic pregnancy, the left tube was swollen and therefore a methylene blue dye test was carried out to confirm blockage. Atraumatic milking, to expose the dye, expelled necrotic tissue which histology confirmed to be a second ectopic pregnancy. She made a good recovery with falling beta-hCG levels and left tubal preservation. As the use of ART increases, bilateral ectopic pregnancies will become more common. Novel and established techniques should be used to help confirm the diagnosis and assist in tubal preservation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Unilateral Atraumatic Expulsion of an Ectopic Pregnancy in a Case of Bilateral Ectopic Pregnancy

Sampson

Mogekwu

Ahmed

et al. 2017

Case Reports in Obstetrics and Gynecology

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“…The management of extra-uterine pregnancy is variable [9] which can be medical, surgical conservative or radical according to multiple criteria [18]. Evolution is generally favorable [2] [19].…”

Section: Commentsmentioning

confidence: 99%

“…Vanita [7] reported a case of ectopic mole associated with a normal intrauterine pregnancy. Bilateral ectopic pregnancy is rare [8] [9]. The subsequent prognosis of fertility is uncertain with a risk of infertility or recurrence of ectopic pregnancy.…”

mentioning

confidence: 99%

Bilateral Tubal Molar and Embryonic Pregnancy

Zamané¹,

Ouedraogo²,

Sawadogo³

et al. 2018

OJOG

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Aim: To report a case of bilateral tubal molar and embryonic pregnancy diagnosed and treated at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso. Observation: It was an 18-year-old patient, G2P0 with no known pathological history. She was received in obstetric emergencies for suspicion of ectopic pregnancy in a two-month amenorrhea context. At the admission, the physical examination had found a sensitivity of the hypogastric region with a cry of the umbilicus and the bleeding. At pelvic ultrasound, the uterus was empty with a medium-abundance pelvic effusion and a left extra uterine mass. The initial rate of beta HCG was 5700 ml IU per ml. A framed laparotomy was carried out. The operative exploration has revealed a right tubal pregnancy cracked and a left unbroken tubal pregnancy. The diagnosis of a bilateral ectopic pregnancy was retained. A right salpingectomy and a left tubal caesarean section were carried out. Histological analysis confirmed the diagnosis of a left embryonic ectopic pregnancy associated with a right molar ectopic pregnancy. Conclusion: The systematic use of histological analysis for any extra uterine pregnancy treatment is required to not ignore an associated molar pregnancy.

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A case report of heterochronic presentation of a bilateral tubal pregnancy

Mansouri,

Tarafdari,

Azizi

et al. 2023

Clinical Case Reports

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Key Clinical MessageThis paper highlights that diagnosis and treatment of one ectopic pregnancy does not rule out the happening of a second ectopic pregnancy in the same patient concurrently, especially if the patient has rising β‐hCG and persistent symptoms.AbstractBilateral tubal pregnancy (BTP) is the most uncommon form of tubal ectopic pregnancy. Complications can lead to maternal morbidity and mortality. We reported a case of left tubal pregnancy and the patient underwent laparoscopic salpingostomy. During the follow‐up, the contralateral ectopic pregnancy was discovered and treated with MTX.

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Bilateral Simultaneous Tubal Ectopic Pregnancy: A Case Report, Review of Literature and a Proposed Management Algorithm

Cited by 19 publications

References 7 publications

Unilateral Atraumatic Expulsion of an Ectopic Pregnancy in a Case of Bilateral Ectopic Pregnancy

Unilateral Atraumatic Expulsion of an Ectopic Pregnancy in a Case of Bilateral Ectopic Pregnancy

Bilateral Tubal Molar and Embryonic Pregnancy

A case report of heterochronic presentation of a bilateral tubal pregnancy

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