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Volume 12, Issue 12 (12-2014)
IJRM 2014, 12(12): 825-0 |
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Goyal L D, Tondon R, Goel P, Sehgal A. Ovarian ectopic pregnancy: A 10 years’ experience and review of literature. IJRM 2014; 12 (12) :825-0
URL: http://ijrm.ir/article-1-500-en.html
URL: http://ijrm.ir/article-1-500-en.html
1- Department of Obstetrics and Gynecology, Guru Gobind Singh Medical College and Hospital, Faridkot, Panjab, India , lajja.goyal@rediffmail.com
2- Department of Obstetrics and Gynecology, Govt. Medical College, Chandigarh, India
2- Department of Obstetrics and Gynecology, Govt. Medical College, Chandigarh, India
Abstract: (2994 Views)
Background: Primary ovarian pregnancy is one of the rarest forms of ectopic pregnancy having incidence of 1/7000-1/40,000 in live births and 0.5-3% of all ectopic gestations. Intrauterine contraceptive device (IUCD), salpingitis, infertility, and assisted reproductive techniques are the important risk factors. Approximately, 75% terminate in first trimester and are often misdiagnosed as corpus luteum haemorrhage. Preoperative diagnosis by ultrasonography (USG) in early pregnancy can help in conservative medical/ surgical management.
Objective: The aim of the present study was to find the incidence, risk factors, role of USG in pre-operative diagnosis, feasibility of conservative management with medical method or minimal invasive surgery in developing countries like India.
Materials and Methods: We did a retrospective cross-sectional study of ovarian pregnancies managed at Government Medical College and Hospital Chandigarh between July 2000 to July 2010. We analyzed the incidence, risk factors, clinical presentation, management of ovarian pregnancy, and reviewed the literature.
Results: Incidence of ovarian pregnancy was 4.9% of all ectopic pregnancies (14/523). Thirteen (93%) patients presented in first trimester with acute pain abdomen and of these ten patients had bleeding per vaginum. One (7%) patient referred from peripheral hospital at term gestation with ultrasonographic diagnosis of breech presention with plecenta previa. Pre-operative diagnosis was made only in two cases (11%). All cases were managed by laparotomy. Excision of the sac with conservation of the ovary was done in eleven cases (78%) and oophorectomy was done in two cases (14%).
Conclusion: Incidence of ovarian pregnancy is on the rise. Although ultrasonography can detect ovarian gestations in unruptured cases but cannot easily differentiate ovarian from other tubal gestation in ruptured state. Medical management is usually not feasible it most of the patients present in ruptured state. Conservative surgical approach is the management of choice.
Objective: The aim of the present study was to find the incidence, risk factors, role of USG in pre-operative diagnosis, feasibility of conservative management with medical method or minimal invasive surgery in developing countries like India.
Materials and Methods: We did a retrospective cross-sectional study of ovarian pregnancies managed at Government Medical College and Hospital Chandigarh between July 2000 to July 2010. We analyzed the incidence, risk factors, clinical presentation, management of ovarian pregnancy, and reviewed the literature.
Results: Incidence of ovarian pregnancy was 4.9% of all ectopic pregnancies (14/523). Thirteen (93%) patients presented in first trimester with acute pain abdomen and of these ten patients had bleeding per vaginum. One (7%) patient referred from peripheral hospital at term gestation with ultrasonographic diagnosis of breech presention with plecenta previa. Pre-operative diagnosis was made only in two cases (11%). All cases were managed by laparotomy. Excision of the sac with conservation of the ovary was done in eleven cases (78%) and oophorectomy was done in two cases (14%).
Conclusion: Incidence of ovarian pregnancy is on the rise. Although ultrasonography can detect ovarian gestations in unruptured cases but cannot easily differentiate ovarian from other tubal gestation in ruptured state. Medical management is usually not feasible it most of the patients present in ruptured state. Conservative surgical approach is the management of choice.
Type of Study: Original Article |
References
1. Raziel A, Golan A, Pansky M, Ron-El R, Bukovsky I, Caspi E. Ovarian pregnancy: A report of twenty cases in one institution. Am J Obstet Gynecol 1990; 163: 1182-1185. [DOI:10.1016/0002-9378(90)90685-Z]
2. Hallatt JG. Primary ovarian pregnancy: a report of twenty-five cases. Am J Obstet Gynecol 1982; 143: 55-60. [DOI:10.1016/0002-9378(82)90683-4]
3. Studzinski Z, Branicka D, Filipczak A, Olinski K. Prolonged ovarian pregnancy: A case report. Ginekol Pol 1999; 70: 33-35. (In Polish)
4. Sergent F, Mauger-Tinlot F, Gravier A, Verspyck E, Marpean L. Ovarian pregnancies: revaluation of diagnostic criteria. Gynecol Obstet Biol Reprod (Paris) 2002; 31: 741-746. (In French)
5. Reichman J, Goldman JA, Feldberg D. Ovarian Pregnancy: Association with IUD, Pelvic pathology and recurrent abortion. Eur J Obstet Gynecol Reprod Biol 1981; 12: 333-337. [DOI:10.1016/0028-2243(81)90078-2]
6. Joseph RJ, Irvine LM. Ovarian ectopic pregnancy: Aetiology, diagnosis, and challenges insurgical management. J Obstet Gynaecol 2012; 32: 472-474. [DOI:10.3109/01443615.2012.673039]
7. Dursun P, Gultekin M, Zeyneloglu HB. Ovarian ectopic pregnancy after ICSI-ET: a case report and literature review. Arch Gynecol Obstet 2008; 278: 191-193. [DOI:10.1007/s00404-008-0562-2]
8. Comstock C, Huston K, Lee W. The ultrasonographic appearance of ovarian ectopic pregnancies. Obstet Gynecol 2005; 105: 42-45. [DOI:10.1097/01.AOG.0000148271.27446.30]
9. Chang FW, Chen CH, Liu JY. Early diagnosis of ovarian pregnancy by ultrasound. Int J Gynecol Obstet 2004; 85: 186-187. [DOI:10.1016/j.ijgo.2003.11.006]
10. Sehgal A, Goyal LD, Goel P, Sunita BS. Full term ovarian pregnancy: A case report. Aust NZ J Obstet Gynecol 2005: 45: 165-166.
11. Choi HJ, Im KS, Jung HJ, Lim KT, Mok JE, Kwon YS. Clinical analysis of ovarian pregnancy: a report of 49 cases. Eur J Obstet Gynecol Reprod Biol 2011; 158: 87-89. [DOI:10.1016/j.ejogrb.2011.04.015]
12. Vahnu C, Rajlaxmi M, Vandana R. Primary Ovarian Pregnancy after Interval Tubal Ligation: A Case Report. J Fam Reprod Health 2013; 7: 187-188.
13. Ghi T, Banfi A, Marconi R, Iaco PD, Pilu G, Aloysio DD, et al. Three-dimensional sonographic diagnosis of ovarian pregnancy. Ultrasound Obstet Gynecol 2005; 26: 102-104. [DOI:10.1002/uog.1933]
14. Juan YC, Wang PH, Chen CH, Ma PC, Liu WM Successful treatment of ovarian pregnancy with laparoscopy-assisted local injection of etoposide. Fertil Steril 2008; 90: 1200.
15. Mittal S, Dadhwal V, Baurasi P. Successful medical management of ovarian Mittal S, Dadhwal V, Baurasi P. Successful medical management of ovarian pregnancy. Int J Gynecol Obstet 2003; 80: 309-310. [DOI:10.1016/S0020-7292(02)00304-1]
16. Bagga R, Suri V, Verma P, Chopra S, Kalra J. Failed Medical Management in Ovarian Pregnancy Despite Favorable Prognostic Factors-A Case Report. Med Gen Med 2006; 8: 35.
17. Odejinmi F, Rizzuto MI, Macrae R, Olowu O, Hussain M. Diagnosis and laparoscopic management of 12 consecutive cases of ovarian pregnancy and review of literature. J Minim Invasive Gynecol 2009; 16: 354-359. [DOI:10.1016/j.jmig.2009.01.002]
18. Koo YJ, Choi HJ, Im KS, Jung HJ, Kwon YS Pregnancy outcomes after surgical treatment of ovarian pregnancy. Int J Gynaecol Obstet 2011; 114: 97-100. [DOI:10.1016/j.ijgo.2011.02.013]
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