title: Spontaneous bilateral tubal pregnancies: a case report.
abstract: BACKGROUND
  Bilateral tubal pregnancies in the absence of preceding induction of ovulation are a rare occurrence, with an estimated incidence of 1 in 725 to 1 in 1580 ectopic pregnancies. They are usually diagnosed at the time of surgery.
  
  
  METHODS
  We report a case of spontaneous bilateral tubal pregnancies diagnosed intraoperatively. Conservative laparoscopic tubal surgery was used to treat the ectopic pregnancies. The patient returned with signs of a persistent ectopic pregnancy and was subsequently treated with methotrexate with resolution of symptoms and normalization of hCG levels.
  
  
  CONCLUSIONS
  The diagnosis of bilateral tubal pregnancy is usually made intraoperatively. This underscores the importance of identifying and closely examining both tubes at the time of surgery, even in the presence of significant adhesive disease.
authors.affiliation: Department of Obstetrics and Gynaecology, Dalhousie University, IWK Health Centre, Halifax NS.
authors.forename: James
authors.initials: J
authors.lastname: Andrews
authors.affiliation: Department of Obstetrics and Gynaecology, Dalhousie University, IWK Health Centre, Halifax NS.
authors.forename: Scott
authors.initials: S
authors.lastname: Farrell
authors.affiliation: Department of Obstetrics and Gynaecology, Dalhousie University, IWK Health Centre, Halifax NS.
authors.forename: James
authors.initials: J
authors.lastname: Andrews
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use; D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008727:Methotrexate / Q000627:therapeutic use; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D008727:Methotrexate