Clinical analysis of women with ovarian pregnancy: a retrospective case–control study

Abstract

Background To address the clinical features and potential risk factors of ovarian pregnancy (OP). Methods In this retrospective case–control study performed in West China Second University Hospital from March 17, 2005 to December 8, 2018, 146 OP patients were selected as a case group, 292 patients with tubal pregnancy (TP) and 292 women with intrauterine pregnancy (IUP) were matched as controls at a ratio of 1:2:2. Results When compared with TP patients, OP patients tend to have worse clinical complications (hemorrhagic shock (7.41% vs 2.89%), rupture of pregnancy sac (54.07% vs 37.78%), hemoperitoneum (363.1 ± 35.46 ml vs 239.3 ± 27.61 ml) and increased need for emergency laparotomy (9.60% vs 3.97%) at an early gestational age. Assisted reproductive technology (ART) (adjusted OR1 2.08, 95%CI 1.04 to 4.18; adjusted OR2 2.59, 95%CI 1.25 to 5.37) and intrauterine contraceptive device (IUD) use (adjusted OR1 2.19, 95%CI 1.10 to 4.36; adjusted OR2 2.77, 95%CI 1.74 to 5.71) may be risk factors for ovarian ectopic pregnancy as compared to the control groups of TP and IUP patients. Conclusions OP patients tend to have more severe clinical complications and this study has identified ART and IUD use as potential risk factors for OP. Results of this study may contribute to improve the understanding of OP and promote early surgical intervention.

Spontaneous dual ectopic pregnancies in the ipsilateral fallopian tube and ovary: A case report and literature review

“…We describe a case of spontaneous concurrent ectopic pregnancies in the left ovary and left fallopian tube after natural conception. Although the rate of dual ovarian and tubal ectopic pregnancies is unknown, we can infer these cases likely occur even more infrequently than ovarian pregnancies with rates of 0.5%–3.2%, 1 and spontaneous bilateral tubal pregnancies with rates of 0.06%–0.14% of all ectopic pregnancies 2 . Previous reports of dual ovarian and tubal ectopic pregnancies in the literature are rare, and most case reports described their occurrence following ovarian induction 3–7 .…”

Ovarian ectopic pregnancy: clinical characteristics, ultrasound diagnosis and management

“…OEP accounts for 1-3% of ectopic pregnancies and 0.03-0.09% of all pregnancies [3][4][5][6] . The reported incidence of OEP appeared to be increasing up to the mid-1990s, but has since remained stable.…”

“…ART has been reported as a risk factor for OEP 6,[20][21][22] , with theories suggesting that high-volume culture medium or stimulation of uterine contractions from a difficult embryo transfer can lead to retrograde movement of embryos through the Fallopian tubes and into the ovary 8,[23][24][25] . Other explanations include ovarian injury after oocyte retrieval, facilitating embryo implantation 26 , and higher number of spermatozoa reaching the ovary following intrauterine insemination 11,27 .…”

“…IUCDs have also been associated with an increased risk of OEP 3,6,14,22,32,33 , thought to be due to altered tubal motility facilitating ovarian implantation 28 . This study did not demonstrate an increased risk of OEP associated with ART, pelvic adhesions or IUCD, although this could be due to the small sample size.…”

“…OEP is associated with significant hemoperitoneum on ultrasound scan 6,8,14,29,36 . In one of the largest studies to date, only 2.5% of OEPs were identified sonographically, but 80% had hemoperitoneum triggering surgical intervention 8 .…”