Ovarian pregnancy: With a report of three cases

Abstract

Three examples of ovarian pregnancy are presented, each of which fulfills the criteria necessary for making such a diagnosis. From the clinical standpoint, one of them presented a diagnostic problem, while the other two presented findings which readily permitted a diagnosis of ectopic pregnancy, and one was an extremely acute case, with extensive intraperitoneal hemorrhage. Cases 2 and 3 represent an unusually early rupture. Study of the specimens revealed in two of them well-developed corpora lutea adjacent to the pregnancy, the so-called juxtafollicular implantation, but whether this was preceded by fertilization in the actual follicle or on the surface of the ovary, it is, of course, impossible to say at the present time. The well-developed and intact corpora lutea so close to the pregnancy rather suggest fertilization in the follicle, followed by rapid invasion of the underlying ovarian stroma. In none of the specimens was any decidual reaction noted.The fate of the ovum in ovarian pregnancy is comparable to that which takes place in other forms of extrauterine pregnancy; namely, development for a period of time, with associated erosion of the adjacent tissues and eventual rupture, with sometimes slight and sometimes severe symptoms. While we have not encountered an example, it is interesting to note that a higher percentage of ovarian pregnancies proceed to term than is the case with tubal pregnancy, this being no doubt due to the more resistant type of tissue in which the pregnancy is embedded.