Primary ovarian pregnancy

Abstract

The objectives of this study were to determine how primary ovarian pregnancy was diagnosed and treated at Chang Gung Memorial Hospital Taipei Taiwan Republic of China between 1980 and 2005 and whether pelvic inflammatory disease (PID) or intrauterine devices (IUDs) played a role in the occurrence of the reviewed ovarian pregnancies. Medical records were reviewed and 54 cases identified. The state of the data base as well as clinical course operative reports treatment results transvaginal ultrasonographic features for early diagnosis and possible relationship between primary ovarian pregnancy and the presence of PID or the use of an IUD were examined. The mean age of the 54 women identified as having been treated for an ovarian pregnancy was 30.4 years (range 21- 46 years). Of these 52 (96%) were suspected of having an ectopic pregnancy preoperatively. The preoperative diagnosis of ovarian pregnancy based on the observation of specific features on transvaginal ultrasonographic scanning was correctly made in 14 cases (26%). The specific sonographic features for preoperative diagnosis were the following: an empty uterus which was seen in all cases (100%); the presence of an ovarian cystic mass with internal echo seen in 8 cases (15%); a characteristic double hyperechogenic ring surrounding a small hypoechogenic field on sonographic evaluation of the ovary seen in 2 cases (4%); a visible gestational sac and fetal heart beat within the ovary seen in 4 cases (7%); and detection of fetal heart beat by transvaginal color Doppler sonography which occurred in 2 cases (4%). Only 13% of the patients were using an IUD and only 8 patients (15%) were found to have PID or pelvic adhesions on surgery. (excerpt)