Bilateral Tubal Pregnancy Following Spontaneous Conception: A Case Report and Literature Review
Bibliographic record
Abstract
Ectopic tubal pregnancy (ETP) continues to be a serious health condition and the leading cause of maternal morbidity and mortality in early pregnancy. Its incidence has increased lately to reach 1.5-2% of all early pregnancies. Bilateral tubal pregnancy (BTP) is the rarest form of extra-uterine pregnancy. It is usually associated with infertility treatment, while spontaneous occurrence is exceptionally rare. The clinical presentation of BTP is unpredictable and the performance of currently available imaging modalities is unsatisfactory, rendering the diagnosis extremely difficult, mostly made during surgery. Herein, we present a case of a 39-year-old patient who presented with a disturbed ectopic pregnancy. Intra-operatively, a ruptured tubal pregnancy, together with another intact ETP in the contralateral tube, was encountered. Salpingectomy and salpingostomy were done respectively preserving the intact tube with uneventful recovery. This was followed by a review of recent literature on BTP. Definitive diagnosis of BTP continues to be made at surgery in spite of some improvement in preoperative detection. Meticulous examination by sonographers of the whole pelvis in early pregnancy should be the routine even in extra-uterine pregnancies. Gynecologists should explore contralateral tube while performing surgery on ETP. Furthermore, close surveillance with clinical, sonographic and serial serum beta-chain human chorionic gonadotropin, should be implemented for all ETP even following salpingectomy. J Clin Gynecol Obstet. 2020;9(3):60-69 doi: https://doi.org/10.14740/jcgo642
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.008 | 0.006 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".