title: Primary Ovarian Ectopic Pregnancy: Still a Medical Challenge.
abstract: OBJECTIVE
  To investigate the clinical presentation of women with primary ovarian pregnancy diagnosed in recent years and to compare it to tubal pregnancy.
  
  
  METHODS
  Seven women treated for primary ovarian pregnancy from 2002-2013 were retrospectively identified and compared to 42 women with tubal pregnancies (involving either tubal rupture or tubal abortion) operated on during the same period. In the ovarian pregnancy group the pathology examination confirmed primary ovarian pregnancy according to the Spiegelberg criteria.
  
  
  RESULTS
  Seven women underwent surgery for primary ovarian pregnancy during the study period. Five women presented with hemodynamic shock. A ruptured ovarian pregnancy was identified in all cases. Wedge resection was performed by laparotomy in 1 case and by laparoscopy in 6 cases. The mean estimated blood loss was significantly higher in those women with ovarian versus tubal pregnancy (1057.1 ± 472.1 mL vs. 250.2 ± 241.5 mL, respectively, p<0.001). Moreover, a statistically significant difference was found when we compared postoperative hospitalization days (2 ± 0.6 vs. 1.3 ± 0.7, respectively; p=0.01) in the ovarian pregnancy group as compared with the tubal pregnancy group.
  
  
  CONCLUSIONS
  Primary ovarian ectopic pregnancy is still a major challenge for early diagnosis and treatment; it is associated with rupture and massive intraabdominal bleeding.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Melcer
authors.forename: Ron
authors.initials: R
authors.lastname: Maymon
authors.forename: Zvi
authors.initials: Z
authors.lastname: Vaknin
authors.forename: Moty
authors.initials: M
authors.lastname: Pansky
authors.forename: Sonia
authors.initials: S
authors.lastname: Mendlovic
authors.forename: Oshri
authors.initials: O
authors.lastname: Barel
authors.forename: Noam
authors.initials: N
authors.lastname: Smorgick
mesh_terms: D000328:Adult; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D011247:Pregnancy; D065172:Pregnancy, Ovarian / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012421:Rupture