title: Combined tubal and cornual pregnancy in a patient without risk factors. A case report.
abstract: BACKGROUND
  Ectopic pregnancy is the leading cause of pregnancy-related death during the first trimester. Bilateral ectopic pregnancy is a rare phenomenon, varying in frequency between 1 per 725 and 1 per 1,580 ectopic pregnancies. We report the case of a bilateral ectopic pregnancy (ruptured right cornual and intact left ampullary) in a patient with no known risk factors for extrauterine gestation.
  
  
  METHODS
  A 33-year-old, black woman, gravida 2, para 1001, presented at approximately 7 weeks' gestation with the acute onset of abdominal pain. She had a rigid surgical abdomen but was hemodynamically stable. Her beta-human chorionic gonadotropin level was 6,398 mIU/mL, and transvaginal ultrasound failed to reveal an intrauterine gestation, adnexal mass or cul-de-sac fluid. Findings at laparotomy included a 500-mL hemoperitoneum and a ruptured right cornual and intact left ampullary pregnancy. Pathology of both specimens confirmed the presence of chorionic villi.
  
  
  CONCLUSIONS
  Although rare, heterotopic pregnancies can occur even in patients without risk factors.
authors.affiliation: Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington 98431, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Rondeau
authors.forename: M L
authors.initials: ML
authors.lastname: Hibbert
authors.forename: K M
authors.initials: KM
authors.lastname: Nelson
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000150:complications* / Q000601:surgery; D011274:Pregnancy, Tubal / Q000150:complications* / Q000601:surgery; D012307:Risk Factors; D012422:Rupture, Spontaneous