title: Simultaneous presentation of tubal and primary abdominal pregnancies following clomiphene citrate treatment.
abstract: Abdominal pregnancy is a rare condition that is potentially life-threatening for the mother. We present a case of simultaneous ectopic pregnancies (EPs) in the right fallopian tube and in the vesicouterine pouch. A 26-year-old woman had undergone prior ovulation induction with clomiphene citrate and human chorionic gonadotropin (hCG) at an outside hospital for unexplained infertility. The patient was referred to our hospital for a suspected ectopic pregnancy at 6 weeks gestation. Transvaginal ultrasonography detected a viable fetus at the anterior left side of the uterus; therefore, we suspected a left tubal pregnancy. However, laparoscopic surgery revealed that EPs were located in both the left vesicouterine pouch and in the right fallopian tube. Resection of the right salpinx and abdominal implant were performed. Histopathological examination confirmed the simultaneous presentation of a primary abdominal pregnancy and a right tubal pregnancy. After surgery, the patient's serum hCG level returned to normal. Concurrent EPs and abdominal pregnancy are very rare. However, it should be noted that reproductive technologies sometimes cause unusual clinical situations. A thorough abdominal inspection is needed.
authors.affiliation: Department of Obstetrics and Gynecology, Sapporo Medical University, South 1 West 16, Sapporo, Hokkaido 060-8543, Japan. tbaba@sapmed.ac.jp
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Baba
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Endo
authors.forename: Keiko
authors.initials: K
authors.lastname: Ikeda
authors.forename: Naoko
authors.initials: N
authors.lastname: Takenami
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shimizu
authors.forename: Miyuki
authors.initials: M
authors.lastname: Morishita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Honnma
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ikeda
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Saito
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D002996:Clomiphene / Q000008:administration & dosage / Q000009:adverse effects*; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D011269:Pregnancy, Abdominal / Q000139:chemically induced* / Q000601:surgery; D011274:Pregnancy, Tubal / Q000139:chemically induced* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D006063:Chorionic Gonadotropin; D002996:Clomiphene