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Bilateral ectopic pregnancy in patient with HIV and modified algorithm.

Dominic Joseph Alexander Edwards1,2, Annabel Smyth3

  • 1Obstetrics and Gynaecology, Mater Mothers' Hospital, Brisbane, Queensland, Australia dom.edwards@mac.com.

BMJ Case Reports
|July 25, 2025
PubMed
Summary

This case report details a rare spontaneous bilateral ectopic pregnancy (BEP) in Western Uganda. It underscores the diagnostic challenges and need for thorough evaluation in suspected BEP cases, particularly in resource-limited settings.

Keywords:
Ectopic pregnancyPregnancyUltrasonography

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Area of Science:

  • Reproductive Medicine
  • Obstetrics and Gynecology
  • Global Health

Background:

  • Ectopic pregnancy is a significant cause of maternal morbidity.
  • Spontaneous bilateral ectopic pregnancy (BEP) is an exceptionally rare condition.
  • Diagnostic challenges exist, especially in resource-limited settings.

Purpose of the Study:

  • To report a rare case of spontaneous bilateral ectopic pregnancy (BEP).
  • To highlight diagnostic difficulties and emphasize thorough evaluation in BEP.
  • To contribute to management strategies and clinical awareness for BEP.

Main Methods:

  • Case report of a patient in Western Uganda presenting with symptoms suggestive of ectopic pregnancy.
  • Utilized transvaginal ultrasound for initial assessment.
  • Confirmed diagnosis through subsequent imaging and intraoperative findings.

Main Results:

  • A spontaneous bilateral ampullary ectopic pregnancy was diagnosed at approximately 7 weeks gestation.
  • One of the ectopic pregnancies had ruptured.
  • The patient had a recent HIV diagnosis on antiretroviral therapy, with no other known risk factors.

Conclusions:

  • BEP presents significant diagnostic challenges, necessitating comprehensive adnexal evaluation.
  • Heightened clinical awareness is crucial, especially in resource-limited environments.
  • A modified algorithm is proposed to aid in the clinical decision-making for suspected BEP.