The Critical Role of Serial β-hCG Monitoring in Diagnosing Bilateral Tubal Pregnancy Following Conservative Surgery.

BACKGROUND: Bilateral tubal pregnancy (BTP) is a rare and diagnostically challenging form of ectopic pregnancy. This report emphasizes the critical importance of serial beta-human chorionic gonadotropin (β-hCG) surveillance following conservative tubal surgery. METHODS: A 29-year-old patient underwent laparoscopic salpingostomy for a right tubal pregnancy. Serial β-hCG measurements were performed postoperatively to monitor trophoblastic activity. RESULTS: Instead of the expected decline, β-hCG levels rose postoperatively (from 809.29 mIU/mL to 942.47 mIU/mL by day 3). This abnormal trend prompted re-evaluation, leading to the identification of a contralateral tubal pregnancy via ultrasonography. Surgical intervention confirmed the diagnosis of BTP. Following the second procedure, β-hCG levels normalized within one month. CONCLUSIONS: Systematic postoperative β-hCG monitoring is essential for the early detection of persistent ectopic pregnancy and rare conditions like BTP. This case demonstrates that vigilant laboratory surveillance can trigger crucial clinical reassessment, thereby preventing diagnostic oversight and guiding effective management.