title: Ovarian ectopic pregnancy: A 10 years' experience and review of literature.
abstract: BACKGROUND
  Primary ovarian pregnancy is one of the rarest forms of ectopic pregnancy having incidence of 1/7000-1/40,000 in live births and 0.5-3% of all ectopic gestations. Intrauterine contraceptive device (IUCD), salpingitis, infertility, and assisted reproductive techniques are the important risk factors. Approximately, 75% terminate in first trimester and are often misdiagnosed as corpus luteum haemorrhage. Preoperative diagnosis by ultrasonography (USG) in early pregnancy can help in conservative medical/ surgical management.
  
  
  OBJECTIVE
  The aim of the present study was to find the incidence, risk factors, role of USG in pre-operative diagnosis, feasibility of conservative management with medical method or minimal invasive surgery in developing countries like India.
  
  
  METHODS
  We did a retrospective cross-sectional study of ovarian pregnancies managed at Government Medical College and Hospital Chandigarh between July 2000 to July 2010. We analyzed the incidence, risk factors, clinical presentation, management of ovarian pregnancy, and reviewed the literature.
  
  
  RESULTS
  Incidence of ovarian pregnancy was 4.9% of all ectopic pregnancies (14/523). Thirteen (93%) patients presented in first trimester with acute pain abdomen and of these ten patients had bleeding per vaginum. One (7%) patient referred from peripheral hospital at term gestation with ultrasonographic diagnosis of breech presention with plecenta previa. Pre-operative diagnosis was made only in two cases (11%). All cases were managed by laparotomy. Excision of the sac with conservation of the ovary was done in eleven cases (78%) and oophorectomy was done in two cases (14%).
  
  
  CONCLUSIONS
  Incidence of ovarian pregnancy is on the rise. Although ultrasonography can detect ovarian gestations in unruptured cases but cannot easily differentiate ovarian from other tubal gestation in ruptured state. Medical management is usually not feasible it most of the patients present in ruptured state. Conservative surgical approach is the management of choice.
authors.affiliation: Department of Obstetrics and Gynecology, Guru Gobind Singh Medical College and Hospital, Faridkot, Panjab, India.
authors.forename: Lajya Devi
authors.initials: LD
authors.lastname: Goyal
authors.affiliation: Department of Obstetrics and Gynecology, Govt. Medical College, Chandigarh, India.
authors.forename: Rimpy
authors.initials: R
authors.lastname: Tondon
authors.affiliation: Department of Obstetrics and Gynecology, Govt. Medical College, Chandigarh, India.
authors.forename: Poonam
authors.initials: P
authors.lastname: Goel
authors.affiliation: Department of Obstetrics and Gynecology, Govt. Medical College, Chandigarh, India.
authors.forename: Alka
authors.initials: A
authors.lastname: Sehgal
keywords: Ectopic pregnancy; Infertility; Ovarian pregnancy