Abstract
Primary ovarian pregnancy is rare and accounts for only 0.5%to 3% of all ectopic pregnancies. The diagnosis is often made intraoperatively and confirmed histopathologically. We present a case of ruptured primary ovarian pregnancy who presented to the emergency services in shock and was initially diagnosed as a ruptured tubal ectopic. However at laparotomy the clinical findings suggested a ruptured ovarian ectopic pregnancy which was confirmed on histopathology. The discussion highlights the difficulty in pre operative diagnosis, role of conservative surgery and the importance of histopathology in the accurate diagnosis of this condition.
Highlights
Histopathology of the specimen from the right ovary showed syntitiotrophobl ast, cytotrophoblast and intermediate trophoblast cells confirmed by immunohistochemistry (IHC) for cytokeratin [fig2]
The widespread use of transvaginal ultrasonography and serum β hCG assays have improved the preoperative diagnosis of ectopic pregnancies, diagnosing ovarian pregnancy remains a challenge and even intraoperatively it may be misdiagnosed as hemorr hagic ovarian cyst
In his study of 25 cases of ovarian pregnancy Hallat showed that inability to distinguish an ovarian pregnancy from a hemorrhagic ovary or ruptured corpus luteum was the most significant finding and that the correct diagnosis was made clinically only in 28% of cases, the remaining being diagnosed on histopathology[4]
Summary
Uttara Aiyer Kohli*1, Atul Kumar Sood[2], Anamika Sinha[3], Hrishikesh Magdum[1] and Madhusudan Dey[1]
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