This is a39-year-old female patient,
commercial occupation, nulliparous, primigravida, 12 weeks of amenorrhea, who
consulted for desire of maternity after 15 years of infertility. The physical
examination showed an abdomen of normal volume, soft and tender in the right
iliac fossa. On vaginal touch, the uterus was of normal volume in an anteverted
anteflexed position, regular surface with palpation at the right adnexa of a
firm mass about 5 cm in diameter, irregular and tender. Free douglas. A
diagnosis of infertility of 15 years was retained. Infertility workup showed a
normal uterus. Right ovary normal volume, left ovary normal volume.
Hysterosalpingography with and without opacification showed signs suggestive of
bilateral hydrosalpinx predominating on the right. There was no obvious uterine
anomaly. The blood biology did not show anything particular. An exploratory
laparoscopy revealed multiple
epiplo-tubero-intestinal adhesions. The right trumpet was dilated and adherent
to an adnexal mass. A large adhesiolysis allowed the release of the right tube,
thus opening the possibility to explore the adnexal mass. The opening of the
mass allowed to individualize bony structures corresponding to the forearm
with the calcified hand, and other less distinct structures. The latter finding
led to the diagnosis of calcified ovarian pregnancy.
References
[1]
Gaubert, P., Dufour, P., Devisme, L., et al. (1999) Ovarian Pregnancy: About an Observation. La Presse Médicale, 28, 2103.
[2]
Grall, J. and Jacques, Y. (1978) Ovarian Pregnancy: About Four Cases. Revue Française de Gynécologie, 73, 139-145.
[3]
Sergent, F., Mauger-Tinlot, F., Gravier, A., et al. (2002) Ovarian Pregnancies: Reassessment of Diagnostic Criteria. Journal of Gynecology Obstetrics and Human Reproduction, 31, 741-746.
[4]
Shahabuddin, A. and Chowdhury, S. (1998) Primary Term Ovarian Pregnancy Superimposed by Intrauterine Pregnancy: A Case Report. Journal of Obstetrics and Gynaecology Research, 24, 109-114.
https://doi.org/10.1111/j.1447-0756.1998.tb00060.x
[5]
Ercal, T., Cinar, O., Mumcu, A., et al. (1997) Ovarian Pregnancy: Relationship to an Intrauterine Device. The Australian and New Zealand Journal of Obstetrics and Gynaecology, 37, 362-364. https://doi.org/10.1111/j.1479-828X.1997.tb02434.x
[6]
Hebertsson, G., Magnusson, S.S. and Benediktsdottir, K. (1987) Ovarian Pregnancy and IUCD Use in a Defined Complete Population. Acta Obstetricia et Gynecologica Scandinavica, 66, 607-610. https://doi.org/10.3109/00016348709022065
[7]
Riethmuller, D., Sautière, L., Benoit, S., et al. (1996) Ultrasonic Diagnosis and Laporoscopic Treatment of an Ovarian Pregnancy: A Case Report and Review of the Literature. Journal of Gynecology Obstetrics and Human Reproduction, 25, 378-241.
[8]
Chahtane, A., Dehaymi, M., Rhrab, B., et al. (1993) Ovarian Pregnancy: About 14 Observations with Review of the Literature. Revue Française de Gynécologie Obstétrique, 88, 35-38.
[9]
Philippe, E., Renaud, R., Dellenbach, P., et al. (1987) Ovarian Pregnancy of 32 Cases. Journal of Gynecology Obstetrics and Human Reproduction, 16, 901-908.
[10]
Cabero, A., Laso, E., Lain, J.M., et al. (1989) Increasing Incidence of Ovarian Pregnancy. The European Journal of Obstetrics & Gynecology and Reproductive Biology, 31, 227-232. https://doi.org/10.1016/0028-2243(89)90157-3
[11]
Beugre, N. (1993) Epidemiological and Anatomical-Pathological Study of Ectopic Pregnancies: About 59 Cases. Specialisation Thesis in Gynaecology and Obstetrics, Abidjan.
[12]
Raziel, A., Schachter, M., Morderchar, S., et al. (2004) Ovarian Pregnancy a 12-Year Experience of 19 Cases in One Institution. The European Journal of Obstetrics & Gynecology and Reproductive Biology, 114, 92-96.
https://doi.org/10.1016/j.ejogrb.2003.09.038
[13]
Grimes, H., Nosal, R. and Gallagher, J. (1983) Ovarian Pregnancy: A Series of 24 Cases. Obstetrics & Gynecology, 61, 174-180.
[14]
Pan, H., Huang, L., Lee, J., et al. (2004) Ovarian Pregnancy Torsion. Archives of Gynecology and Obstetrics, 270, 119-121.
https://doi.org/10.1007/s00404-002-0407-3
[15]
Bouzid, F., Cellami, D., Baati, S., et al. (1996) Abdominal Pregnancy. French Journal of Gynaecology and Obstetrics, 91, 616-618.