Ovarian ectopic pregnancy: a review article

Dr Pragati Meena,Dr Poonam Bhojwani,Dr Gajendra Singh Verma

doi:10.17511/joog.2017.i04.06

Dr Pragati Meena, Dr Poonam Bhojwani + Show 1 more

Open Access

https://doi.org/10.17511/joog.2017.i04.06

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Abstract

Ectopic pregnancy is a major health issue in reproductive age group female. Incidence of primary ovarian ectopic pregnancy as mentioned in literature of India is variable from 0.001% to 0.014% of normal pregnancies. Only 0.15% to 3.0% of all ectopic pregnancy occurs in ovary and it is 2ndmost common site of ectopic pregnancy after fallopian tube. Annual incidence of extra uterine cavity pregnancy is rising over past 3 yrs. The aim of ourpresent study isto find out the incidence of ovarian ectopic pregnancy, role of USG in pre-operative diagnosisand risk factors, feasibility of conservative management with medical method or conservative management e.g. minimal invasive surgery in developing countries like India. We analysed the incidence, management of ovarian pregnancy & reviewed the literature, risk factors and clinical presentation of ovarian ectopic pregnancies managed at NIMS Medical College and Hospital jaipur. According to Spielberg criteria, it is a diagnostic challenge to obstetrician. Diagnosis of ectopic pregnancy can be missed radio logically and intra operatively. It Should be suspected in patients presented with rupturedectopic pregnancy, ultrasound features suggestive of normal bilateralfallopian tube with hemo peritoneum with breached ovarian surface. Conservative surgical approach is preferred, now days Medical management is preferred for unruptured ectopic pregnancy. Confirmation of ovarian pregnancy done only after histopathological report. Now daysMedical management with single dose of Methotrexate is very successful for un ruptured ovarian pregnancy

Highlights

The Incidence of ectopic pregnancy is 1.2-1.4%
0.15% to 3.0% of all ectopic pregnancy occurs in ovary and it is 2nd most common site of ectopic pregnancy after fallopian tube [1]
IUCD is found in 1532% of patients of non ovarian ectopic pregnancy and 60-92% of patient of ovarian ectopic pregnancy

Summary

Introduction

The Incidence of ectopic pregnancy is 1.2-1.4%. Incidence of primary ovarian ectopic pregnancy is, as mentioned in literature of Indiais variable from 0.001% to 0.014% of normal pregnancies. 0.15% to 3.0% of all ectopic pregnancy occurs in ovary and it is 2nd most common site of ectopic pregnancy after fallopian tube [1]. Extra uterine pregnancy or ectopic ovarian pregnancy a Greek word originated from “EKTOPOS” which means out of place. Primary ovarian ectopic pregnancy is very rare clinical presentation of extra uterine pregnancy & a life threatening emergency if not diagnosed timely. Fallopian tube is most common site of ectopic pregnancy, comprises to 95% of total ectopic pregnancies. Ovarian pregnancy is gestational sac implantation in the ovary. 75% pregnancies terminate in early gestation, 12.5% patients terminate in the second trimester & 12.5 % patients reached till term. Ovarian pregnancyin 1624, suggested first by Mercerus[3,4]

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Discussion

Conclusion