Spontaneous bilateral ectopic pregnancy: A case report.
Njoku C1, Oriji PC1*, Aigere EOS1,2, Omile C2
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.
2Department of Obstetrics and Gynaecology, Shepherd Hospital and Fertility Centre, Warri, Delta State, Nigeria.
*Correspondence: Dr. Oriji, Peter Chibuzor; +234 706 423 3209; firstname.lastname@example.org
Download full article in pdf format
Background: Ectopic pregnancy is deﬁned as the implantation of a fertilised ovum at a site other than the uterine endometrium. Worldwide, ectopic pregnancy complicates 0.25 – 2% of all pregnancies. Bilateral ectopic pregnancy is rare. It occurs in 1 out of every 200,000 spontaneous pregnancies and range from 1 out of every 725 to 1,580 ectopic pregnancies. Ectopic pregnancy is one of the commonest causes of ﬁrst trimester maternal mortality in our environment.
Case presentation: She was a 39-year-old G4P2 (2 alive) lady who presented to the emergency unit following 6 weeks of amenorrhoea with bilateral ectopic pregnancy. At laparotomy, there were right and left ruptured ampullary ectopic gestations. Right and le par al salpingectomy was done and repaired with No. 1 vicryl suture. The haemoperitoneum was evacuated. She recovered and was counselled on invitro fertilisation if she is still desirous of pregnancy.
Conclusion: Ectopic pregnancy is associated with increased risk of maternal morbidity and mortality. Early presentation to the hospital, high index of suspicion, availability of diagnostic facilities and functional blood transfusion services are key in reducing the morbidity and mortality associated with ectopic pregnancy.
Keywords: Ectopic pregnancy, Bilateral ectopic pregnancy, Morbidity and mortality, Laparotomy, Salpingectomy.
Cite this article: Njoku C, Oriji PC, Aigere EOS, Omile C. Spontaneous bilateral ectopic pregnancy: A case report. Yen Med J. 2019;1(1):56-60.
- Hale G, Aysegul B, Engin C, Gokhan Unruptured live ectopic pregnancy at 11 weeks gestation. Instanbul Med J. 2016;17:110–112.
- Yakassai IA, Abdullahi J, Abubakar Management of ectopic pregnancy in Aminu Kano teaching hospital, Kano, Nigeria. Glo Adv Res J Med Med Sci. 2012;1(7):181–185.
- Rana P, Singh R, Afzal Ectopic pregnancy: A review. Arch Gynaecol Obstet. 2013;288(4):747–757.
- Joshua HB, Edward MB, Hillson Diagnosis and management of ectopic pregnancy. Am Acad Fam Physician. 2014;90(1):34–40.
- Andrews J, Farrell S. Spontaneous bilateral tubal pregnancies: a case report. J Obstet Gynaecol 2008;30:51–54.
- Mol F, van Mello NM, Strandell Salpingotomy versus salpingectomy in women with tubal pregnancy (ESEP study): an open-label, multicentre, randomised controlled trial. Lancet. 2014;383:1483–1489.
- Institute of obstetricians and gynaecologists, Royal College of Physicians of Ireland. Clinical Practice Guideline The diagnosis and management of ectopic pregnancy, Guideline No: 33. Available from: https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.14189. Updated November, 2017. Accessed May 2, 2019.
- Ugboma HA, Oputa OA, Orazulike NC, Allagoa Ectopic pregnancy: Recent experience in a tertiary Hospital, South-Southern Nigeria. Int J Trop Dis Health. 2017;21(1):1–6.
- Udigwe GO, Umeononihu OS, Mbachu II. Ectopic pregnancy: A 5-year review of cases at Nnamdi Azikiwe University Teaching Hospital (NAUTH) Niger Med J. 2010;51(4):160–163.
- Weiss A, Beck-Fruchter R, Golan J, Lavee M, Geslevich Y, Shalev E. Ectopic pregnancy risk factors for ART patients undergoing the GnRH antagonist protocol: a retrospective Reprod Biol Endocrinol. 2016;14(12):1–8.
- Igwegbe AO, Eleje GU, Okpala An appraisal of the management of ectopic pregnancy in a Nigerian tertiary hospital. Ann Med Sci Res. 2013;3(2):166–170.
- Akaba GO, Agida TE, Onafowokan Ectopic pregnancy in Nigeria’s federal capital territory: A six-year review. Niger J Med. 2012;21(2):241–245.
- Mayank M, Mohammed O, Andrew WH. Ectopic pregnancy. Obstet Gynecol Reprod 2017;27:245–250.
- Ikechebelu JI, Eke NO, Okafor Laparoscopic salpingectomy for ruptured tubal ectopic pregnancy: A case report. Ann Med Health Sci Res. 2017;7:203–205.
- Condous Ectopic pregnancy. In: Edmunds DK, ed. Dewhurst’s Textbook of Obstetrics and Gynaecology. 9th ed. West Sussex, UK: John Wiley and Sons, Ltd; 2018:589–596.
- Junior JE. Clinical treatment of unruptured ectopic pregnancy. In: Kamrava M, ed. Ectopic Pregnancy – Modern Diagnosis and London, UK: IntechOpen; 2011:178–208. Available from: https://www.intechopen.com/books/ectopic-pregnancy-modern-diagnosis-and-management/clinical-treatment-of-unruptured-ectopic-pregnancy. Published October 26, 2011. Accessed May 5, 2019.
- Sumant RS, Sandip S, Bhavesh P, Nidhi Medical management of ectopic pregnancy with methotrexate. Indian J Clin Pract. 2014;24(11):1048–1052.
- Vanitha NS, Emma K, Duncan WC, Shephard Diagnosis and management of ectopic pregnancy.