• Xi Zeng, Li Luo, and Yun-Wei Ou-Yang.
• Department of Gynecology and Obstetrics, The West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
• Medicine (Baltimore). 2021 Jan 15; 100 (2): e24291e24291.

RationaleIn this article, we report interesting clinical manifestation of spontaneous bilateral fallopian tube pregnancies in a patient with a didelphic uterus.Patient ConcernsA 26-year-old female patient, gravida 2, para 0 + 1, suffered from progressive abdominal pain and vaginal bleeding. A laboratory exam revealed a human chorionic gonadotropin level of 1091 IU/L. Transvaginal ultrasound detected no embryo sacs in the uterus but revealed a didelphic uterus, and a mass measuring 39 mm x 32 mm in the left adnexa region with another mass measuring 42 x 28 mm in the right adnexa region.DiagnosesAn ectopic pregnancy in the left adnexa region and a corpus hemorrhagicum in the right adnexa region were suspected.InterventionsLaparoscopic exploration operation confirmed a didelphic uterus, and pathological biopsy revealed bilateral fallopian tube pregnancies.OutcomesThe patient made a good recovery and the human chorionic gonadotropin became normal within the following 2 months.LessonsTo the best of our knowledge, clinical manifestation of spontaneous bilateral fallopian tube pregnancies in a patient with a didelphic uterus has never been reported before. Based on the experience with this case, we suggest that if a gestational sac is found in 1 fallopian tube, the contralateral fallopian tube needs to be examined for an ectopic pregnancy during surgery.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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