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Accurate preoperative diagnosis of ovarian pregnancy with transvaginal scan.

Gupta N, Gupta A, Onyema G, Pantofel Y, Ying SC, Garon JE, Lampley C, Blankstein J - Case Rep Obstet Gynecol (2012)

Bottom Line: Ovarian pregnancy is a rare variant of ectopic pregnancy, and an accurate preoperative diagnosis is very challenging.Transvaginal ultrasonography is a valuable tool in identifying an ovarian pregnancy from other types of ectopic pregnancies.This case history demonstrates the use of ultrasonography (USG) and surgery in the diagnosis and treatment, respectively, of the ovarian pregnancy.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Mount Sinai Hospital, 1500 S California Avenue, Chicago, IL 60608, USA.

ABSTRACT
Ovarian pregnancy is a rare variant of ectopic pregnancy, and an accurate preoperative diagnosis is very challenging. Dr. Saint Monnissey described the first reported case of ovarian pregnancy in 17th century. Transvaginal ultrasonography is a valuable tool in identifying an ovarian pregnancy from other types of ectopic pregnancies. Management with laparoscopy or laparotomy is required in all cases, and in almost all cases, ovary can be preserved since implantation is usually superficial (Koo et al.; 2011). A single case of an ovarian pregnancy, consistent with Spiegelberg's criteria is presented here. This case history demonstrates the use of ultrasonography (USG) and surgery in the diagnosis and treatment, respectively, of the ovarian pregnancy. As we step into an era where in vitro fertilization rate is on its hike, one should be aware that incidence of ovarian pregnancy is also increasing, necessitating a high index of suspicion.

No MeSH data available.


Related in: MedlinePlus

Histopathology revealed ovary with immature chorionic villi consistent with ectopic pregnancy. On the left lower field there are immature chorionic villi. On the right side is ovarian stroma with a primoridal follicle by the double arrows.
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fig3: Histopathology revealed ovary with immature chorionic villi consistent with ectopic pregnancy. On the left lower field there are immature chorionic villi. On the right side is ovarian stroma with a primoridal follicle by the double arrows.

Mentions: Vital signs were within normal limits. The quantitative beta hcg was 7744 mIU/mL. The hemoglobin level was at 12.7 gm/100 mL and the hematocrit was at 38.1%. A diagnosis of right ovarian gestation was made. Patient was informed of the diagnosis and a minilaparotomy was performed. Intraoperative findings revealed a normal right tube and fimbria, completely separate from the right ovary; a surgically absent left tube, a normal left ovary, minimal blood in the cul de sac, and a 1.5 cms nodular lesion on the right ovarian surface. A wedge resection of the nodular lesion was performed. The histopathological examination showed immature chorionic villi in the wall of the gestational sac (Figure 3), consistent with the ectopic ovarian gestation. The above mentioned intraoperative and the pathological findings fulfilled the Spiegelberg criteria [1], formulated in 1878, by Spiegelberg, for the correct diagnosis of ovarian pregnancy.


Accurate preoperative diagnosis of ovarian pregnancy with transvaginal scan.

Gupta N, Gupta A, Onyema G, Pantofel Y, Ying SC, Garon JE, Lampley C, Blankstein J - Case Rep Obstet Gynecol (2012)

Histopathology revealed ovary with immature chorionic villi consistent with ectopic pregnancy. On the left lower field there are immature chorionic villi. On the right side is ovarian stroma with a primoridal follicle by the double arrows.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3472540&req=5

fig3: Histopathology revealed ovary with immature chorionic villi consistent with ectopic pregnancy. On the left lower field there are immature chorionic villi. On the right side is ovarian stroma with a primoridal follicle by the double arrows.
Mentions: Vital signs were within normal limits. The quantitative beta hcg was 7744 mIU/mL. The hemoglobin level was at 12.7 gm/100 mL and the hematocrit was at 38.1%. A diagnosis of right ovarian gestation was made. Patient was informed of the diagnosis and a minilaparotomy was performed. Intraoperative findings revealed a normal right tube and fimbria, completely separate from the right ovary; a surgically absent left tube, a normal left ovary, minimal blood in the cul de sac, and a 1.5 cms nodular lesion on the right ovarian surface. A wedge resection of the nodular lesion was performed. The histopathological examination showed immature chorionic villi in the wall of the gestational sac (Figure 3), consistent with the ectopic ovarian gestation. The above mentioned intraoperative and the pathological findings fulfilled the Spiegelberg criteria [1], formulated in 1878, by Spiegelberg, for the correct diagnosis of ovarian pregnancy.

Bottom Line: Ovarian pregnancy is a rare variant of ectopic pregnancy, and an accurate preoperative diagnosis is very challenging.Transvaginal ultrasonography is a valuable tool in identifying an ovarian pregnancy from other types of ectopic pregnancies.This case history demonstrates the use of ultrasonography (USG) and surgery in the diagnosis and treatment, respectively, of the ovarian pregnancy.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Mount Sinai Hospital, 1500 S California Avenue, Chicago, IL 60608, USA.

ABSTRACT
Ovarian pregnancy is a rare variant of ectopic pregnancy, and an accurate preoperative diagnosis is very challenging. Dr. Saint Monnissey described the first reported case of ovarian pregnancy in 17th century. Transvaginal ultrasonography is a valuable tool in identifying an ovarian pregnancy from other types of ectopic pregnancies. Management with laparoscopy or laparotomy is required in all cases, and in almost all cases, ovary can be preserved since implantation is usually superficial (Koo et al.; 2011). A single case of an ovarian pregnancy, consistent with Spiegelberg's criteria is presented here. This case history demonstrates the use of ultrasonography (USG) and surgery in the diagnosis and treatment, respectively, of the ovarian pregnancy. As we step into an era where in vitro fertilization rate is on its hike, one should be aware that incidence of ovarian pregnancy is also increasing, necessitating a high index of suspicion.

No MeSH data available.


Related in: MedlinePlus