Diagnosis and management of ectopic ovarian pregnancy: a rare case report

Bouab, Maryem; Touimi, Ahmed Benjelloun; Jalal, Mohamed; Lamrissi, Amine; Fichtali, Karima; Bouhya, S.

doi:10.1016/j.ijscr.2021.106742

Cited by 8 publications

(11 citation statements)

References 12 publications

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“…It could be a secondary ovarian pregnancy or extrafollicular type of both primary and secondary ovarian pregnancy [7]. The diagnosis in this case was made on multiple findings in the operative field, confirmed with postoperative imaging and the second-look operation [8].…”

Section: Discussionmentioning

confidence: 61%

Advanced Ovarian Pregnancy: A Case Report of Misdiagnosis and Surgical Outcomes

Whangteeranon

Pinyochotiwong

2022

Case Reports in Obstetrics and Gynecology

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Background. Ovarian pregnancy is rare and difficult to diagnose preoperatively, especially in advanced gestational age. Misdiagnosis can increase the chance of emergent complications. Case. A misdiagnosed case of a 33-week ovarian pregnancy woman who underwent surgery due to a preoperative diagnosis of a dead fetus in utero, and transverse lie was reported with eventful surgical outcomes. This case resulted in the delivery of a dead fetus and a sudden massive hemorrhage that occurred after placental detachment. Oophorectomy could not be performed due to severe bowel adhesions and multiple feeding vessels from the bowel at the posterior part of the left ovary. The placental site was sutured at multiple sites, and local hemostatic agents were placed for hemostasis. Postoperatively, she received multiple transfusions and was safely discharged after 10 days. Conclusion. Obstetricians must be acutely aware of this condition, especially while performing sonography preoperatively, for better outcomes.

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Section: Discussionmentioning

confidence: 61%

Advanced Ovarian Pregnancy: A Case Report of Misdiagnosis and Surgical Outcomes

Whangteeranon

Pinyochotiwong

2022

Case Reports in Obstetrics and Gynecology

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Section: Introductionmentioning

confidence: 99%

“…Its incidence is 0.5% to 1% of all ectopic gestations, or 1 in 7000 to 40,000 live births. 1 The diagnosis is intricate and based on surgical and histopathological observations and its recognition is imperative as it can be potentially life-threatening when intraabdominal bleeding and potentially shock occurs. 1,2 According to current literature, ruptured ovarian ectopic pregnancy is rarely diagnosed preoperatively, as it shares similarities with other more prevalent abdominal structures at emergencies.…”

Section: Introductionmentioning

confidence: 99%

“…1 The diagnosis is intricate and based on surgical and histopathological observations and its recognition is imperative as it can be potentially life-threatening when intraabdominal bleeding and potentially shock occurs. 1,2 According to current literature, ruptured ovarian ectopic pregnancy is rarely diagnosed preoperatively, as it shares similarities with other more prevalent abdominal structures at emergencies. 2,3 Although transvaginal ultrasound is a valuable diagnostic method to detect early ovarian pregnancy, specific ultrasound features that aid a preoperative diagnosis may not always be visible.…”

Section: Introductionmentioning

confidence: 99%

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Challenges of Management of Ruptured Second Trimester Ovarian Pregnancy in Low-and Middle-Income Settings: A Case Report

Eleje

Udigwe

Njoku

et al. 2023

Clin Med Insights Case Rep

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Background: Ovarian ectopic pregnancy is a rare form of non-tubal ectopic pregnancy. It can rupture before the end of the first trimester, causing hemoperitoneum, and present with signs and symptoms similar to other commoner abdominal emergencies or the pregnancy can continue intraperitoneally. Therefore, they are not often diagnosed preoperatively. Ultrasound can assist in diagnosis of ovarian ectopic pregnancy but the findings could be ambiguous or inconclusive. We present a case of ruptured ovarian ectopic pregnancy at the second trimester causing massive hemoperitoneum that was suspected as an intrabdominal malignancy co-existing with intrabdominal pregnancy. Case presentation: She was a 34 year-old Nigerian unbooked G4P3+0, (3 alive), who presented to the labor ward on 21st January, 2021 with a complaint of a 6-week history of abdominal pain and swelling. Pain was insidious in onset, generalized, non-colicky, non-radiating, constant, no known aggravating or relieving factor, but it was of moderate intensity. She had amenorrhea with a positive serum pregnancy test without prior early ultrasound. At presentation, initial abdominopelvic ultrasound revealed intra-uterine viable pregnancy but repeat ultrasound done showed a left adnexal ectopic gestation and an echo-rich intraperitoneal fluid collection. Laparotomy was done and ovarian pregnancy was accurately diagnosed intra-operatively. Tissue samples from the ovary confirmed normal products of conception, namely chorionic villi, trophoblastic cells and ovarian stroma at histology. Conclusion: Despite advances in imaging techniques, the diagnosis of ovarian ectopic gestation is still very difficult. When premenopausal women present with amenorrhea, generalized non-colicky abdominal pain and swelling in combination with ambiguous findings of pregnancy on ultrasound in the absence of trauma, differential diagnoses should include ruptured ovarian pregnancy. Obstetricians should maintain a high index of suspicion to forestall delayed diagnosis and the potential maternal morbidity and mortality. However, the need for high-index of suspicion should be for any ectopic, not just ovarian pregnancy.

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“…Ovarian pregnancies are a rare form of ectopic pregnancy, occurring in 0.5% to 1% of ectopic gestations, or 1 in 7000 to 40,000 live births (1,7). Although a potentially lifethreatening event, the pathophysiology is not understood and the diagnosis remains challenging (8).…”

Section: Introductionmentioning

confidence: 99%

Ovarian Pregnancy: A Systematic Review and 2 Case Reports

Almahloul¹,

Amro²,

Nagshabandi³

et al. 2022

Preprint

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Objective Ovarian pregnancy is a rare but well-known pathology. However, pathophysiology, diagnosis and treatment are not clearly established. Data sources. All case reports published in Pubmed from Nov 2011 till Nov 2022. Study eligibility criteria. A systematic review and 2 case reports of ovarian pregnancy Study appraisal and synthesis methods. Not applicable Results Ovarian pregnancies occur in 8% of women without or blocked oviducts and in 23% on the other side than the corpus luteum and the symptoms of ovarian pregnancies are not specific. Therefore ovarian pregnancy has to be suspected in all women with abdominal bleeding. As for extrauterine pregnancies, the presence of an intrauterine pregnancy does not rule out an ovarian pregnancy. Surgical excision is the preferred treatment. Important is that in women with both an intra-uterine and an ovarian pregnancy, care should be taken not to damage the corpus luteum. Conclusions Ovarian pregnancies can occur in women with blocked tubes, on the other side of the corpus luteum, in the presence of an intrauterine pregnancy, and even when pregnancy tests or tranvaginal ultrasonography are negative. The diagnosis being difficult to exclude, a laparoscopy is indicated in all women with intra-abdominal bleeding, keeping in mind that an intra-uterine pregnancy cannot be exluded and that a corpus luteum need to be respected.

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Diagnosis and management of ectopic ovarian pregnancy: a rare case report

Cited by 8 publications

References 12 publications

Advanced Ovarian Pregnancy: A Case Report of Misdiagnosis and Surgical Outcomes

Advanced Ovarian Pregnancy: A Case Report of Misdiagnosis and Surgical Outcomes

Challenges of Management of Ruptured Second Trimester Ovarian Pregnancy in Low-and Middle-Income Settings: A Case Report

Ovarian Pregnancy: A Systematic Review and 2 Case Reports

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