Laparoscopic management of ovarian pregnancy.
BACKGROUND
Ovarian pregnancy (OP) comprises 0.15% of all pregnancies and 1% to 3% of ectopic gestations.


METHODS
Two cases of OP detected and treated during laparoscopy for suspected ectopic pregnancy are described. We used clinical examination, serum beta-hCG levels, and transvaginal ultrasonography (TVS) preoperatively to confirm the suspected diagnosis of extrauterine pregnancy. In the first patient, oophorectomy was performed, whereas the second patient was treated by an ovarian wedge resection to restore and preserve ovarian integrity. Postoperative recovery periods were normal in both patients, with no further therapeutic intervention in the follow-up course.


CONCLUSIONS
Primary OP may occasionally occur in patients with a suspected ectopic pregnancy. Signs and symptoms suggestive of extrauterine pregnancy, TVS, and serum beta-hCG dynamics can be a useful adjunct to allow the preoperative diagnosis of OP prior to the use of the diagnostic gold standard, diagnostic laparoscopy. Preservation of ovarian tissue should be the therapeutic goal to maintain ovarian reserve and preserve fertility in young women with OP.
Tinelli
Andrea
A
Department of Obstetrics and Gynaecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com
Hudelist
Gernot
G
Malvasi
Antonio
A
Tinelli
Raffaele
R
D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis / Q000601:surgery*