title: Primary Ovarian Pregnancy: 43 Years Experience in a Single Institute and still a Medical Challenge.
abstract: BACKGROUND
  Despite awareness regarding tubal pregnancy, ovarian pregnancy still remains a diagnostic challenge. The correct diagnosis is most frequently made intraoperatively and requires histopathologic confirmation. Therefore, additional diagnostic measurements are needed for earlier and more accurate detection of ovarian pregnancies which will allow more rapid and efficient treatment.
  
  
  OBJECTIVE
  To assess the time trends, clinical manifestations, surgical management and post-procedure outcome of 46 primary ovarian pregnancies in a single institution during three time periods.
  
  
  METHODS
  In this retrospective study we compared 20 patients with primary ovarian pregnancy during the years 1971- 1989 (first period), 19 patients in 1990-2001 (second period) and 7 patients in 2002-2013 (third period). In all cases the pathology examination confirmed primary ovarian pregnancy.
  
  
  RESULTS
  The number of tubal ectopic pregnancies almost doubled, from 637 in the first period to 1279 in the third period (P < 0.001). However, there was a significant fall in the number of ovarian ectopic pregnancies, from 20 cases in the first period to 7 cases in the third (P = 0.009). A significant difference was noted when we compared the postoperative hospitalization time (4.06 ± 1.4 vs. 2.0 ± 0.6 days respectively, P = 0.001) in the second versus the third time period.
  
  
  CONCLUSIONS
  Ovarian pregnancy continues to be a diagnostic challenge, associated with a high rate of circulatory collapse, hemoperitoneum and requirements for blood transfusions, all leading to longer hospitalization.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Melcer
authors.forename: Noam
authors.initials: N
authors.lastname: Smorgick
authors.forename: Zvi
authors.initials: Z
authors.lastname: Vaknin
authors.forename: Sonia
authors.initials: S
authors.lastname: Mendlovic
authors.forename: Arieh
authors.initials: A
authors.lastname: Raziel
authors.forename: Ron
authors.initials: R
authors.lastname: Maymon
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data*; D005260:Female; D006465:Hemoperitoneum / Q000453:epidemiology* / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D011247:Pregnancy; D065172:Pregnancy, Ovarian / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012769:Shock / Q000453:epidemiology* / Q000209:etiology; D013997:Time Factors