Ruptured Ovarian Ectopic Pregnancy: A Case Report
Rajika S Bhat,
520, Bldg No. 8, Kamat Royale Kerant Caranzalem, Panjim, Goa, India.
|Ovarian pregnancy is a rare form of ectopic pregnancy. It accounts for 0.5-3% of all non tubal ectopics and the incidence ranges from 1 in 7000 to 1 in 40,000 deliveries. Review of literature suggests its possible association with risk factors like Intrauterine Contraceptive Device (IUCD) use, endometriosis, pelvic inflammatory disease, previous ectopics, previous tubal surgery, tubal sterilisation, use of ovulation induction agents and the use of Assisted Reproductive Techniques (ARTs). Clinical and ultrasound picture often mimics tubal ectopic pregnancy, haemorrhagic ovarian cyst and corpus luteal cyst, thus posing a challenge to the gynaecologist or surgeon. Accurate diagnosis can be made only intraoperatively using Spiegelberg’s criteria followed by histopathological confirmation. Treatment includes wedge resection of affected ovarian tissue followed by ovarian reconstruction or salpingo-oophorectomy. The author hereby reports A case of a young second gravida with previous full term normal vaginal delivery who presented with amenorrhoea along with hypogastric pain and a syncopal attack. Transvaginal Sonography (TVS) revealed left sided ruptured ectopic gestation with massive haemoperitoneum. During laparotomy, left sided ruptured ectopic pregnancy was diagnosed and wedge resection of the ovary followed by ovarian reconstruction was done. Histopathological examination confirmed it as an ovarian ectopic pregnancy. The incidence of ovarian pregnancy is on the rise with an increase in the use of ARTs and hence it is imperative to keep a high suspicion index and consider it in the differential diagnosis of acute lower abdominal pain in all women of childbearing age who present to the emergency department. High resolution transvaginal sonography may lead to earlier and precise detection of ovarian pregnancies and decrease the risk of complications like rupture, secondary implantation, haemorrhagic shock and maternal mortality.|
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