Concurrent Ipsilateral Acute And Chronic Ectopic Pregnancies

Introduction This report describes a unique case of concurrent chronic and acute ectopic pregnancies in an ipsilateral tube. Case History A 33-year-old woman presented with symptoms suggestive of miscarriage that resolved on conservative management, resulting to normal βhCG level. However, she was readmitted 5 weeks later with vaginal spotting, right iliac fossa pain and slightly elevated βHCG. A diagnosis of pregnancy of unknown location was made and she was managed conservatively. Four weeks later the patient presented once again with vaginal bleeding and a positive pregnancy test. Her serum βhCG level was elevated and her pelvic ultrasound scan showed an adnexal mass. The patient therefore underwent laparoscopic salpingectomy. Histopathological examination showed two ectopic pregnancies within the same tube; an older (chronic) ectopic positioned within proximal end of the tube and a more recent one at the distal end. Conclusion This case highlights the difficulty in diagnosing chronic ectopic pregnancy and the increased risk of recurrence after conservative management.