Ovarian Ectopic Case Study

Introduction:

Ovarian ectopic is an uncommon form of ectopic gestation, accounting for 0.15- 3% of all ectopics. [1]It is often difficult to diagnose; frequently the first clinical sign is shock. Though transvaginal ultrasound is invaluable in the diagnosis of an ovarian pregnancy, it can be mistaken for a hemorrhagic corpus luteum or ovarian cyst. Ovarian pregnancy occurs in a fertile patient in contrast to tubal ectopic pregnancy (which is more frequently associated with infertility) and has been shown to have significant association with IUCD use. [2] We present a case of primary ovarian ectopic managed successfully by operative laparoscopy.

Case Report:

A 22 year old female patient presented in the casualty with acute abdominal pain since

He outlined four criteria for the diagnosis of primary ovarian gestation: 1. The fallopian tube with its fimbriae must be intact; 2. The gestational sac should occupy the normal position of the ovary; 3. The gestational sac should be connected to the uterus by the uterine ovarian ligament; and 4. The ovarian tissue must be present in the specimen attached to the gestational sac. Subsequently , other authors stated that ovarian tissue must be present around the gestational sac in several positions, at some distance from one another; in addition, the tube must not only be intact, but must also be free from any evidence of gestation, thus eliminating the possibility of secondary ovarian implantation. Even at the time of surgery, differential diagnosis between ovarian pregnancy and bleeding corpus luteum may be difficult. Macroscopic examination alone is insufficient and only indirect signs may be indicative.[2] In the present case, dilatation of the tube and active bleeding from the ovary made the diagnosis of the site of ectopic, difficult. Hence a salpingo- oophorectomy was done to get a definitive diagnosis after histopathological examination which confirmed the diagnosis of a primary ovarian