Bilateral Spontaneous Twin Tubal Ectopic Pregnancy: Case Report

Abstract

Ectopic pregnancy is a condition where the fertilized oocyte gets implanted outside the uterus. Tubal ectopic
pregnancy accounts for 95 % of the ectopic gestation. Remaining 5 % involves the ovaries, cervix, cornua,
abdominal and scar site pregnancies. Spontaneous ectopic pregnancy occurs when there is no prior infertility
treatment taken. Bilateral spontaneous tubal ectopic pregnancy is a rare form of ectopic gestation. Hereby
I would discuss a case of spontaneous bilateral ectopic pregnancy and its outcome. Case: A 35 years old
gravid 2 abortion 1 with secondary infertility of 13 yrs came to emergency casualty with complaints of lower
abdominal pain, spotting per vagina with giddiness and syncopal attack.
Diagnosis: Based on clinical findings of acute anaemia due to internal blood loss and free fluid in the
lower abdomen with fullness on forniceal palpation and bulky uterus. Trans abdominal ultrasonography was
confirmatory in diagnosing bilateral adnexal mass with free fluid in pouch of Douglas.
Intervention: Emergency exploratory laparotomy with adequate blood transfusion. Patient recovered
uneventfully.
Conclusion: Women in reproductive age group with history of amenorrhoea with irregular spotting and acute
abdominal pain with syncopal attack should be managed vigorously keeping in mind ectopic pregnancy so
as to have less morbidity and chances of good future pregnancy. Salphingotomy as an alternative method
should be practiced.