Ovarian Ectopic Pregnancy After Intrauterine Insemination: Case Report

Öz

Ectopic pregnancy is defined as implantation of fertilized ovum in an area other than endometrial lining of uterus. The most common localization for ectopic pregnancy is the ampullary portion of the fallopian tube. Ovarian pregnancy is a rare form of ectopic pregnancy and represents 1-3% of all ectopic pregnancies. The incidence is estimated to be between 1/2100 and 1/7000 of pregnancies. Incidence is rising due to the increasing use of intrauterine device, ovulation induction and assisted reproductive techniques. Clinical and intraoperative diagnosis may be difficult. In this case report, an extrauterin ectopic pregnancy after IUI procedure is presented with no acute abdomen and shock signs that could be treated conservatively via laparascopy.

Anahtar Kelimeler

• Ovarian ectopic pregnancy,intrauterine insemination,laparascopy.

İntrauterin İnseminasyon Sonrası Ovaryan Gebelik: Olgu Sunumu

Öz

Ektopik gebelik fertilize ovumun endometrium dışında herhangi bir yere implante olmasıdır. En sık lokalizasyonu fallop tüpü ve tüpün ampuller segmentidir. Nadir olarak görülen ovaryan ektopik gebelik, tüm ektopik gebeliklerin %1-3’ünü oluşturmaktadır. İnsidansın tüm gebeliklerin 1/2100 ila 1/7000’i arasında olduğu düşünülmektedir. Günümüzde insidans, artan rahim içi araç kullanımı, ovulasyon indüksiyonu ve yardımla üreme teknikleri nedeniyle artmaktadır. Klinik ve intraoperatif olarak tanı koymak zor olabilir. Bu vaka takdiminde intrauterin inseminasyon IUI sonrası gelişen ve preopertatif dönemde akut batın ve şok bulguları olmaksızın laparoskopi ile konservativ olarak tedavi edilen ovaryan ektopik gebelik vakası sunulmuştur.

Anahtar Kelimeler

• Ovaryan ektopik gebelik,intrauterine inseminasyon,laparoskopi

Kaynakça

1. Comstock C, Huston K, Lee W. The ultrasonographic appearance of ova- rian ectopic pregnancies. Obstet Gynecol 2005;105:42–45.
2. Gaudoin MR, Coulter KL, Robins AM, Verghese A, Harretty KP. Is the incidence of ovarian ectopic pregnancy increasing? Eur J Obstet Gynecol Reprod Biol 1996;70:141– 143.
3. Das S, Kalyani R, Lakshmi V, Kumar MLH. Ovarian Pregnancy. Indian J of Pathology and Microbiology 2008;51:37-38.
4. Roy J, SinhaBabu A. Ovarian pregnancy: two case reports. Australas Med J. 2013;31: 406-14.
5. Spiegelberg O. ZurCasuistik den Ovarial-Schwangenschaft. Arch Gynae- col 1878;13:73.
6. Choia H-J, Imb K-S, Jungb H-J, Lima K-T, Moka J-E, Kwon Y-S. Clinical analysis of ovarian pregnancy: a report of 49 cases. Europ J of Obstet&- Gynecol and Reprod Biol 2011:158:87–89.
7. Raziel A, Schachter M, Mordechai E, Friedler S, Panski M, Ron-El R. Ovarian pregnancy—a 12-year experience of 19 cases in one institution. Eur J Obstet Gynecol Reprod Biol 2004;114:92-6.
8. Sergent F, Mauger-Tinlot F, Gravier A, Verspyck E, Marpeau L. Ovarian pregnancies: revaluation of diagnostic criteria [in French]. J Gynecol Obstet Biol Reprod (Paris) 2002;31:74.

9. Var T, Tonguc EA, Akan E, Batioglu S, Akbay S. Laparoscopic conserva- tive approach to ovarian pregnancies: two cases. Arch Gynecol Obstet 2009;280: 123–5.
10. Mol BW, Lijmer JG, Ankum WM, et al. The accuracy of single serum progesterone measurement in the diagnosis of ectopic pregnancy: a me- ta-analysis. Hum Reprod 1998; 13:3220.
11. Lipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ectopic pregnancy. N Engl J Med 2000;343: 1325–9.
12. Odejinmi F, Rizzuto MI, Macrae R, Olowu O, Hussain M. Diagnosis and la- paroscopic management of 12 consecutive cases of ovarian pregnancy and review of literature. J Minim Invasive Gynecol 2009;16:354-9