Abstract

*Dr. F. Kamri, K. Tamim, R. Watfeh, Pr. M. Yousfi and Pr. S. Bargach

ABSTRACT

Bilateral ectopic pregnancy is a rare twin pregnancy with only a few cases reported in the literature. We report the case of a 38-year-old woman with no particular pathological history or high-risk factors for ectopic pregnancy, who had a concomitant bilateral ectopic pregnancy. This 38-year-old woman presented to the obstetrical emergency department with diffuse abdominal pain. The presumptive diagnosis of ruptured right ectopic pregnancy was made on the basis of the clinical and para-clinical findings. An emergency laparotomy was performed revealing a hemoperitoneum of 2L, two ruptured tubal pregnancies, one left and one right with active bleeding. A bilateral salpingectomy was performed. Histopathology revealed the presence of chorionic villus in both tubes. Laparoscopic salpingotomy is the best surgical approach for bilateral tubal pregnancy. However, salpingectomy may be necessary in bilateral ectopic pregnancy when both tubes are severely damaged or actively bleeding. Successful pregnancies have been reported after conservative surgical treatment of bilateral ectopic pregnancies, but the risk of recurrence is high. Our decision to perform an emergency laparotomy followed by bilateral salpingectomy was based on the fact that the patient presented with an acute abdomen and was hemodynamically unstable, and there were numerous bilateral tubal lesions. As the incidence of ectopic pregnancies increases along with the incidence of pelvic lesions inflammatory diseases and the use of assisted fertility techniques; it may be that these "rare ectopics" will become somewhat common.