Spontaneous Bilateral Ectopic Pregnancy in a Patient With Endometriosis


      Background Bilateral ectopic pregnancies (EPs) occur in 1 of 200,000 pregnancies. Evidence suggests that endometriosis is an independent risk factor for unilateral EPs. However, the link between endometriosis and bilateral EPs has not been established.
      Case Report We report a case of a bilateral EP in a patient with endometriosis. The patient was initially misdiagnosed with the unilateral EP.
      Why Should an Emergency Physician Be Aware of This? Although rare, bilateral EP should be on a differential diagnosis in a pregnant patient presenting with abdominal pain or vaginal bleeding. This includes patients presenting with worsening symptoms after the recent surgery for the unilateral EP. Endometriosis as a risk factor for bilateral EP cannot be established based on a single report, but such a report should raise awareness of the issue.


      To read this article in full you will need to make a payment


      Subscribe to Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Yong PJ
        • Matwani S
        • Brace C
        • al Et
        Endometriosis and ectopic pregnancy: a meta-analysis.
        J Minim Invasive Gynecol. 2020; 27: 352-361
        • Barnhart KT
        • Sammel MD
        • Gracia CR
        • al Et
        Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies.
        Fertil Steril. 2006; 86: 36-43
        • Jønler M
        • Rasmussen KL
        • Lundorff P.
        Coexistence of bilateral tubal and intrauterine pregnancy.
        Acta Obstet Gynecol Scand. 1995; 74: 750-752
        • Amine BH
        • Haythem S.
        Extra-uterine twin pregnancy: case report of spontaneous bilateral tubal ectopic pregnancy.
        Pan Afr Med J. 2015; 20: 435
        • Ghomian N
        • Lotfalizadeh M.
        Spontaneous unruptured bilateral tubal pregnancy: a case report.
        Iran J Med Sci. 2015; 40: 537-540
        • Jacob L
        • Kalder M
        • Kostev K.
        Risk factors for ectopic pregnancy in Germany: a retrospective study of 100,197 patients.
        Ger Med Sci. 2017; 15: Doc19
        • De Los Rios J
        • Castaneda J
        • Miryam A.
        Bilateral ectopic pregnancy.
        J Minim Invasive Gynecol. 2007; 14: 419-427
        • Baghdadi T
        • Salle B
        • Bordes A
        • et al.
        Simultaneous bilateral tubal ectopic pregnancy after intracytoplasmic sperm injection and embryo transfer, in a patient with Stage 3 endometriosis.
        Gynecol Minim Invasive Ther. 2017; 6: 199-201
        • Farland LV
        • Prescott J
        • Sasamoto N
        • al Et
        Endometriosis and risk of adverse pregnancy outcomes.
        Obstet Gynecol. 2019; 134: 527-536
        • Hwang A
        • Chou L
        • Islam MM
        • et al.
        Risk factors for ectopic pregnancy in the Taiwanese population: a retrospective observational study.
        Arch Gynecol Obstet. 2016; 294: 779-783
        • Vannuccini S
        • Clifton VL
        • Fraser IS
        • et al.
        Infertility and reproductive disorders: impact of hormonal and inflammatory mechanisms on pregnancy outcome.
        Hum Reprod Update. 2016; 22: 104-115