Received May 05, 2023
Accepted November 21, 2023

Introduction: Bilateral ectopic pregnancy is very rare. Although the frequency of ectopic bilateral pregnancy has increased with the advent of medically assisted procreation, spontaneous bilateral tubal pregnancies remain rare. Early detecting of this type of ectopic pregnancy is important to prevent maternal mortality and morbidity. Conservative surgery must also be considered, as preservation of both tubes is presumed to offer better fertility prospects. We report the case of a 35-year-old patient at 05 weeks of amenorrhea whose discovery of bilaterality was made via ultrasound and confirmed during laparotomy. Case: A 35-year-old woman with a history of three vaginal deliveries, non-smoker, under contraception with microprogestins, presented with pelvic pain and amenorrhea of 5 weeks of gestation. A beta HCG assay came back positive. The pelvic ultrasound revealed a moderate hemoperitoneum and an empty uterus with hematometra. It showed also heterogeneous left and right adnexal masses measured 3 cm and 4 cm respectively. An emergency laparotomy was performed. Per-operatively, two bilateral tubal pregnancies of 3 cm and 4 cm were founded. The patient received conservative treatment with bilateral salpingotomy. The postoperative course was simple without any complication. Conclusion: The diagnosis of spontaneous bilateral tubal ectopic pregnancy is rare and is often established at the time of surgery, hence the importance of a rigorous and vigilant examination of the two tubes during ultrasound examination and surgery so as not to miss it and to better prevent maternal mortality. Conservative surgery should be carefully chosen.