Primary ovarian pregnancy: a report of four cases

Yıl 2011, Cilt: 16 Sayı: 4, 277 - 280, 22.01.2013

Mehmet Aytaç Yüksel Remzi Abalı Fehmi Ünal İlkbal Temel Ahmet Birtan Boran

Öz

Abstract. Primary ovarian pregnancy is a rare form of ectopic pregnancy that constitutes 0.15-3 % of all ectopic pregnancies. Ovarian pregnancy results from the fertilization of trapped ovum within the follicle. Exact pre-operative diagnosis is often difficult, and with a few exceptions, the initial diagnosis is made on the operation table and the final diagnosis only through histopathology. The treatment of choice for ovarian pregnancy is usually ovarian wedge resection or oophorectomy, also there is a place for medical treatment of selected patients. Between October 2005 and May 2010, four cases of ovarian pregnancy that were detected and treated during laparotomy for suspected rupture of ectopic pregnancy are described. Three cases were treated by ovarian wedge resection. In one case, a single dose of 50 mg/m² methotrexate treatment was given, but the same mentioned surgical procedure were performed due to rupture of gestation. In all cases diagnoses were confirmed by pathologic examination. We aimed to discuss a rare form of ectopic pregnancy, primary ovarian pregnancy, and highlight the diagnostic criteria

Key words: Ovarian pregnancy, ectopic pregnancy

Anahtar Kelimeler

-

Kaynakça

• Kraemer B, Kraemer E, Guengoer E, Ovarian ectopic pregnancy: diagnosis, treatment, correlation to Carnegie stage 16 and review based on a clinical case. Fertil Steril 2009; 92: 13-15.
• Nwanodi O, Khulpateea N. The preoperative diagnosis of primary ovarian pregnancy. J Natl Med Assoc 2006; 98: 796-798.
• Bontis J, Grimbizis G, Tarlatzis BC, Miliaras D, Bili H. Intrafollicular ovarian pregnancy after ovulation induction/intrauterine insemination: pathophysiological aspects and diagnostic problems. Hum Reprod 1997; 12: 376-378.
• Yıldızhan R, Adalı E, Yıldızhan B, Süer N. Primary ovarian pregnancy and intrauterine device: a report of two cases. Van Medical Journal 2008; 15: 61-63.
• Marret H, Hamamah S, Alonso AM, Pierre F. Case report and review of the literature: primary twin ovarian pregnancy. Hum Reprod 1997; 12: 1813– 1815.
• Check JH, Chase JS. Ovarian pregnancy with contralateral corpus luteum. Am J Obstet Gynecol 1986; 54: 155-156.
• Comstock C, Huston K, Lee W. The ultrasonographic appearance of ovarian ectopic pregnancies. Obstet Gynecol 2005; 105: 42–45.
• Ghi T, Banfi A, Marconi R, Three-dimensional sonographic diagnosis of ovarian pregnancy. Ultrasound Obstet Gynecol 2005; 26: 102–104.
• Comstock C, Huston K, Lee W. The ultrasonographic appearance of ovarian ectopic pregnancies. Obstet Gynecol 2005; 105: 42-45
• Stein MW, Ricci ZJ, Novak L, Robert SJH, Koenigsberg M. Sonographic comparison of the tubal ring of ectopic pregnancy with the corpus luteum. J Ultrasound Med 2004; 23: 57-62.
• Mittal S, Danhwal V, Baurasi P. Successful medical management of ovarian pregnancy. Int J Gynecol Obstet 2003; 80: 309-310.
• Juan YC, Wang PH, Chen CH, Ma PC, Liu WM. Successful treatment of ovarian pregnancy with laparoscopy-assisted local injection of etoposide. Fertil Steril 2008; 90: 1-2.
• Lipscomb GH, McCord ML, Stovall TG, Predictors of success with methotrexate treatment in women with tubal ectopic pregnancies. N Engl J Med 1999; 341: 1974-1978.
• Potter MB, Lepine LA, Jamieson DJ. Predictors of success with methotrexate treatment of tubal ectopic pregnancy at Grady Memorial Hospital. Am J Obstet Gynecol 2003; 188: 1192-1194.
• Takacs P, Rodriguez L. High folic acid levels and failure of single-dose methotrexate treatment in ectopic pregnancy. Int J Gynecol Obstet. 2005; 89: 301-302.
• Takacs P, Chakhtoura N, De Santis T, Verma U. Evaluation of the relationship between endometrial thickness and failure of single-dose methotrexate in ectopic pregnancy. Arch Gynecol Obstet 2005; 272: 269-272.