Primary ovarian pregnancy.
BACKGROUND
Primary ovarian pregnancy is a relatively rare form of ectopic pregnancy with an incidence of 1/6000 - 1/40000 pregnancies.


METHODS
A 25-year-old woman, gravida 1, parity 0, presented with vaginal bleeding after 8 weeks of amenorrhea. Pelvic examination revealed a left adnexal mass and transvaginal ultrasound confirmed a left adnexal echocomplex mass with free fluid in the cul-de-sac. Serum beta hCG was 3441 mIU/mL. Emergency exploratory laparotomy was performed with a preoperative diagnosis of left ectopic pregnancy, suspected of ovarian pregnancy. Ruptured left ovarian pregnancy was intraoperatively diagnosed. Left salpingo-oophorectomy was performed. The histopathology confirmed ovarian pregnancy. She was well at discharge and throughout a 4-week period of follow-up.


CONCLUSIONS
Although primary ovarian pregnancy is rare and difficult to diagnose clinically and even intraoperatively, it can be detected early with the use of combined transvaginal ultrasonography and serum beta hCG The standard of care is conservative treatment in order to preserve the patient's fertility.
Phupong
Vorapong
V
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Rama IV Road, Pathumwan, Bangkok 10330, Thailand. vorapong.p@chula.ac.th
Ultchaswadi
Pornthip
P
D000328:Adult; D000568:Amenorrhea; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D006801:Humans; D007813:Laparotomy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000503:physiopathology*
D018997:Chorionic Gonadotropin, beta Subunit, Human