Introduction
Ectopic pregnancy is a common emergency but life-threatening condition that obstetricians and gynecologists face and requires fast and careful management. Ectopic pregnancy (EP) is related as the extra uterine implantation and development of the blastocyst. The incidence of EP has raised in developed countries in the past 30 years [1]. The leading risk factors of EP in women are Pelvic inflammatory disease, previous pelvic surgery, tubal infertility, and congenital uterine abnormalities. (2,3) While unilateral tubal pregnancy accounts for 90% of all EPs, bilateral tubal pregnancy (BTP) is considered the most uncommon form [4]. It is difficult to estimate the accurate frequency which is based on case reports, however, the highest reported incidence was 1 in 200,000 pregnancies [5]. This demonstrates 1/750 - 1,500 of all EPs [6]. Complications such as severe bleeding and hypovolemic shock associated with maternal morbidity and mortality are the results of misdiagnosis or delayed diagnosis of EP (2,3). In this case, we report a patient with bilateral tubal pregnancy, and the presentations were not at the same time which makes it more life-threatening and harder to diagnose.