Bilateral Alive Tubal Ectopic Pregnancy and its Management

Ectopic pregnancy is an important cause of maternal mortality. Bilateral tubal pregnancies are rare; The reported incidence is only 1 in 200 000 pregnancies. Detecting bilateral tubal ectopic pregnancy is urgent because of the associated morbidity and mortality1 The management of bilateral tubal ectopic pregnancies may be medical or surgical, and depends to a large extent on the state of the fallopian tubes at presentation. The main challenge being to identify and treat as early as possible .Risk factors for ectopic pregnancy comprises of previous ectopic pregnancy, tubal damage secondary to tubal surgery, Adhesions secondary to previous laparotomies, chronic infection and Endometriosis. Other nonspecific factors that might contribute to an increased risk are cigarette smoking, age more than 35 years, and use of Assisted reproductive technology( ovulation induction). Presentation to the health care services may varies widely from mild vaginal bleeding and lower back and abdominal pain to clinically unstable condition and shock due to ruptured ectopic and life threatening internal bleeding.