The Unexpected Ovarian Pregnancy at Laparoscopy: A Review of Management

Clinical analysis of women with ovarian pregnancy: a retrospective case-control study

Background

To address the clinical features and potential risk factors of ovarian pregnancy (OP).

Methods

In this retrospective case–control study performed in West China Second University Hospital from March 17, 2005 to December 8, 2018, 146 OP patients were selected as a case group, 292 patients with tubal pregnancy (TP) and 292 women with intrauterine pregnancy (IUP) were matched as controls at a ratio of 1:2:2.

Results

When compared with TP patients, OP patients tend to have worse clinical complications (hemorrhagic shock (7.41% vs 2.89%), rupture of pregnancy sac (54.07% vs 37.78%), hemoperitoneum (363.1 ± 35.46 ml vs 239.3 ± 27.61 ml) and increased need for emergency laparotomy (9.60% vs 3.97%) at an early gestational age. Assisted reproductive technology (ART) (adjusted OR1 2.08, 95%CI 1.04 to 4.18; adjusted OR2 2.59, 95%CI 1.25 to 5.37) and intrauterine contraceptive device (IUD) use (adjusted OR1 2.19, 95%CI 1.10 to 4.36; adjusted OR2 2.77, 95%CI 1.74 to 5.71) may be risk factors for ovarian ectopic pregnancy as compared to the control groups of TP and IUP patients.

Conclusions

OP patients tend to have more severe clinical complications and this study has identified ART and IUD use as potential risk factors for OP. Results of this study may contribute to improve the understanding of OP and promote early surgical intervention.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12884-022-05099-8.

[Ovarian pregnancy case study and literature review]

Ovarian pregnancy is a rare entity among ectopic pregnancies. Its diagnosis and management are not always easy. It is a particular pathology, the clinician is confronted with a poor clinical semiology and a difficult ultrasound diagnosis. The surgical criteria remain difficult to prove. We have compiled a case of ovarian pregnancy. The patient consulted our emergency room for pelvic pain, metrorrhagia and amenorrhea of nine weeks. The preoperative diagnosis was evoked by ultrasound which showed a right latero uterine image of 7*8cm at the expense of the right ovary. An emergency laparotomy was performed. Surgical treatment was radical after the failure of conservative treatment. Ovarian pregnancy is a rare entity of ectopic pregnancy which presents certain semiological peculiarities. Its diagnosis is difficult and is based on intraoperative findings. Its therapeutic management remains for the treatment of ectopic pregnancies, despite the progress of medical and surgical treatment.