Embarazo ectópico bilateral. Reporte de caso

Abstract

Introduction: Bilateral ectopic pregnancy is the rarest form of extrauterine pregnancy and is extremely difficult to diagnose, occurring in 1% of pregnancies. The first publication of bilateral ectopic pregnancy was reported many years ago, reporting around 200 cases to date. Some of the countries that have reported these clinical cases are Chile, Mexico, and Colombia, among others. Furthermore, the diagnosis is based on clinical laboratory tests (human chorionic gonadotropin, progesterone, and others) and transvaginal ultrasound. Clinical case presentation: Female patient, 33 years old, AGO [Gynecology and Obstetrics Antecedents by its Spanish acronym]: G: 1, P: 1, C: 0, A: 0, referred clinical picture of 15 days of moderate transvaginal bleeding, accompanied by pain in the hypogastrium region with an intensity of 7/10 on the VAS scale, attended with ultrasound of ectopic pregnancy with amniotic sac, was evaluated and it was decided to admit her with surgical expectation. An exploratory laparotomy was performed, with findings of hemoperitoneum of approximately 300 ml, an injured right ectopic pregnancy, presenting an adnexal mass in the plastering phase +/- 8 cm, an uninjured left tubal ectopic pregnancy +/- 3cm, a macroscopically normal left ovary, hemorrhage of approximately 350 ml, diagnosing bilateral ectopic pregnancy resolved by right tubal adnexectomy plus partial left salpingectomy. Conclusions: Bilateral ectopic pregnancy is a rare pathology worldwide, and in our environment, the diagnosis is based on clinical symptoms, laboratory tests (human chorionic gonadotropin and progesterone), transvaginal ultrasound, and its treatment consists of surgery