Edwards Dominic Joseph Alexander, Smyth Annabel
Obstetrics and Gynaecology, Mater Mothers' Hospital, Brisbane, Queensland, Australia
School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
BMJ Case Rep. 2025 Jul 25;18(7):e266357. doi: 10.1136/bcr-2025-266357.
This case report describes a rare occurrence of spontaneous bilateral ectopic pregnancy (BEP) in a woman in her 30s, at approximately 7 weeks of gestation in Western Uganda. The patient presented with worsening lower abdominal pain, light vaginal bleeding and vomiting. Initial transvaginal ultrasound suggested a unilateral ectopic pregnancy; however, subsequent imaging and intraoperative findings confirmed bilateral ampullary ectopic pregnancies, one of which had ruptured. This woman had a recent diagnosis of HIV on antiretroviral therapy; she otherwise had no history of assisted reproductive technologies or other risk factors. This case highlights the diagnostic challenges of BEP, emphasising the importance of thorough adnexal evaluation during imaging and intraoperative assessment. The report contributes to existing literature by discussing risk factors and management strategies while advocating for heightened clinical awareness, especially in resource-limited settings. A modified algorithm is attached to guide clinical decision-making regarding suspected BEP. .
本病例报告描述了乌干达西部一名30多岁女性在妊娠约7周时罕见的自发性双侧异位妊娠（BEP）情况。患者出现下腹部疼痛加剧、少量阴道出血和呕吐症状。最初的经阴道超声检查提示单侧异位妊娠；然而，后续的影像学检查和术中发现证实为双侧壶腹部异位妊娠，其中一侧已破裂。该女性最近被诊断出感染艾滋病毒并正在接受抗逆转录病毒治疗；除此之外，她没有辅助生殖技术史或其他危险因素。本病例突出了BEP的诊断挑战，强调了在影像学检查和术中评估期间对附件进行全面评估的重要性。该报告通过讨论危险因素和管理策略，同时倡导提高临床意识，特别是在资源有限的环境中，为现有文献做出了贡献。附上了一种改良算法，以指导关于疑似BEP的临床决策。
