Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

A Rare Case of Bilateral Ectopic Pregnancy and Differential Diagnosis of Gestational Trophoblastic Disease

Authors
Maliheh Arab 1
Seyyedeh Neda Kazemi 1
Zahra Vahedpoorfard 2
Adeleh Ashoori 1
1 Preventative Gynecology Research Center (PGRC), Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Kashan University of Medical Sciences, Kashan, Iran
Abstract
Background: Bilateral ectopic pregnancy is a rare condition and is divided in two subgroups, primary and secondary, based on history of assisted reproductive technology. Case Presentation: A 30 year old primigravid woman with history of infertility and ovulation induction presented to a hospital in Kashan in year 2013. She had vaginal bleeding, abdominal pain and ultrasound findings suggested early pregnancy. Due to high titer of β-HCG, gestational trophoblastic disease was proposed and D8C was done in referral and admission to gyneco-oncology ward in Tehran. Repeat sonography suggested ectopic pregnancy in left side and repeat β-HCG level showed an increase of 19435 mIU/ml. Laparotomy findings revealed bilateral ampullary ectopic pregnancy. Bilateral salpingostomy followed by one course of methotrexate was prescribed. Conclusion: Bilateral ectopic gestation should be considered as a rare differential diagnosis for ectopic pregnancy. In this study, bigger size and rupture in left side was observed.
Keywords
Ectopic pregnancy
Reproduction Techniques
Rupture
  1. Oron G, Tulandi T. A pragmatic and evidence-based management of ectopic pregnancy. J Minim Invasive Gynecol. 2013;20(4):446-54.
  2. De Los Rios JF, Castaneda JD, Miryam A. Bilateral ectopic pregnancy. J Minim Invasive Gynecol. 2007;14(4):419-27.
  3. Bloch AJ, Bloch SA, Lyon M. Correlation of β-human chorionic gonadotropin with ultrasound diagnosis of ectopic pregnancy in the ED. Am J Emerg Med. 2013;31(5):876-7.
  4. Ghaffari F, Eftekhari Yazdi P, Kiani K. A case report of bilateral tubal ectopic pregnancy following day 5 embryo transfer. Arch Med Sci. 2011;7(6):1087-8.
  5. Sergent F, Verspyck E, Marpeau L. [Management of ectopic pregnancies complicating in vitro fertilization: a remarkable case of bilateral ectopic pregnancy with independent courses of the pregnancies]. J Gynecol Obstet Biol Reprod (Paris). 2003;32(3 Pt 1):256-60. French.
  6. Mahmood NA, Sandhu AK. Ruptured ovarian cysts and bilateral ectopic pregnancy complicating a case of severe ovarian hyperstimulation syndrome. Saudi Med J. 2005;26(6):982-4.
  7. Shenoy JV, Choudhary V, Giles RW. Bilateral ectopic pregnancy. J Obstet Gynaecol. 2005;25(6):612-3.
  8. Marcovici I, Scoccia B. Spontaneous bilateral tubal ectopic pregnancy and failed methotrexate therapy: a case report. Am J Obstet Gynecol. 1997;177(6):1545-6.
  9. Fernandez H, Capmas P, Lucot JP, Resch B, Panel P, Bouyer J, et al. Fertility after ectopic pregnancy: the DEMETER randomized trial. Hum Reprod. 2013;28(5):1247-53.
  10. Rani VRS, Puliyath G. Viable intrauterine pregnancy after spontaneous bilateral tubal ectopics in a multiparous woman: a case report. J Med Case Rep. 2013;7:159.
  11. Derchin W, Hemstock J, Weder Ch. Bilateral simultaneous tubal pregnancies. Can Med Assoc J. 1956;75(8):669-72.
  12. Geiger GL, McGhee N Jr. Bilateral ruptured tubal pregnancies associated with oral contraceptives. J Natl Med Assoc. 1971;63(5):321-2.
  13. Brady J, Wilson M. Spontaneous bilateral tubal ectopic pregnancy. J R Soc Med. 2005;98(3):120-1.
Journal of Reproduction & Infertility
Volume 16, Issue 1
Winter 2015
Pages 49-52