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Case Report
Volume 2 Issue 2 - 2018
More Examples of Bilateral Simultaneous Tubal Ectopic Pregnancy in a Developing Community
Wilson Onuigbo1* and F Ezugwu2
1Pathology Department, National Orthopaedic Hospital, Enugu, Nigeria
2Gynaecology Department, Park Lane Specialist Hospital, Enugu, Nigeria
*Corresponding Author: Wilson Onuigbo, Pathology Department, National Orthopaedic Hospital, Enugu, Nigeria.
Received: November 15, 2017; Published: May 16, 2018
Abstract
Among the Igbo ethnic group in Nigeria, twin pregnancy is known to be common. A rare form published personally consisted of two cases occurring in the capital city of Enugu within a fortnight; during it, each tube exhibited its own fetus. Incidentally, both patients were twins themselves. Concerning the present two examples, both were documented also in Enugu, the capital city. This phenomenon was noted 4 times in Indian Journals. Their discussion is deemed to be worthy of documentation.
Keywords: Fallopian tubes; Tubal pregnancies; Twinning; Igbo ethnic group; Nigeria
Introduction
An indigenous ethnic group in Nigeria is the Ibo or Igbo [1]. Previously, the author co-authored 2 cases aged 23 years and 28 years respectively with coexisting bilateral tubal pregnancies [2]. These are acknowledged to be a rarity. Incidentally, from India, four typical cases have been documented [3-6]. Bilateral simultaneous tubal ectopic pregnancy (BTP) is acknowledged as the rarest forms of ectopic pregnancy. Therefore, another 2 cases are worthy of documentation from the community which had previously been the source of this rare entity.
Case Reports
Case 1: A Para O, 20-year-old Igbo woman, complained of generalized abdominal pain of a week’s duration with associated watery stooling and vomiting. She was menstruating. Clinically, she was ill-looking, febrile, pale, and anicteric with thready pulse and low blood pressure. There was generalized abdominal tenderness. Left abdominal quadrant tap was hemorrhagic. As urgent Laparotomy revealed the presence of conceptus materials in both tubes, biopsies were carried out. Two masses were received by the senior author (WO). On microscopy, both showed the presence of chorionic villi classically.
Case 2: MO, a 35-year-old woman with unstated parity came with low abdominal pain, bleeding per vaginam and fainting attack of a day’s duration. Pregnancy test was positive. At operation, the tissues from the points of ruptures from both tubes were biopsied and submitted to the senior author (WO) who found thus:
Specimen A – 5 cm tube with distended middle portion
Specimen B – 2 cm distorted mass with obvious chorionic villi.
On microscopy, each tube manifested clots and chorionic villi abundantly.
Discussion
While this report was in preparation, classical cases in two other Igbo patients came to our knowledge [7]. Incidentally, both were managed expeditiously and the recovery was each uneventful. Their emphases were on the need for early presentation, high index of suspicion, good case selection, and judicious intra-operative suspicion of the contralateral tube and histology of the specimens.
From India [8], it was the opinion of Rani and Puliyath that “Bilateral ectopic pregnancies are increasing due to an increase in the incidence of pelvic inflammatory disease and increase in assisted reproductive techniques.” Moreover, Saudi Arabian authors were also of this view [9]. In our local case, much as the possibility of pelvic inflammatory disease cannot be discounted, there was no question as to the use of assisted techniques of reproduction.
References
  1. Basden GT. “Niger Ibos”. Cass, London 1966.
  2. Onuigbo WIB., et al. “Twin proneness associated with two extraordinary cases of coexistence of bilateral tubal pregnancies”. Journal of College of Medicine 12.1 (2007): 5-7.
  3. Jena SK., et al. “Bilateral simultaneous tubal pregnancy: A case report, review of literature and a proposed management algorithm”. Journal of Clinical and Diagnostic Research 10.3 (2016): QD01-QD03.
  4. Sheeba M and Supriya G. “Spontaneous bilateral tubal gestation: A rare case report”. Case Reports in Obstetrics and Gynecology 2016 (2016).
  5. Kaur P., et al. “Concurrent bilateral ectopic pregnancy: A rarity”. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 4.4 (2015): 1197-1199.
  6. Jahagirda SS and Junghare PS. “A rare case of bilateral spontaneous tubal ectopic pregnancy”. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 3.4 (2014): 1116-1118.
  7. Eze JN., et al. “Bilateral tubal ectopic pregnancies: A report of two cases”. Annals of African Medicine 11.2 (2012): 112-115.
  8. Sreeja Rani VR and Puliyath G. “Viable intrauterine pregnancy after spontaneous bilateral tubal ectopic in a multiparous woman: A case report”. Journal of Medical Case Reports 7 (2013): 159.
  9. Othman M., et al. “Bilateral ectopic pregnancy: Case report”. WebmedCentral Obstetrics and Gynaecology 4.7 (2013): WMC004354.
Citation: Wilson Onuigbo and F Ezugwu. “More Examples of Bilateral Simultaneous Tubal Ectopic Pregnancy in a Developing Community”. Gynaecology and Perinatology 2.2 (2018): 247-249.
Copyright: © 2018 Wilson Onuigbo and F Ezugwu. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.