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Hemoperitoneum: a diagnostic dilemma. A solid ovarian tumour mimicking ruptured ectopic pregnancy  [cached]
Wills G. Sheelaa,Jayasree Manivasakan
International Journal of Reproduction, Contraception, Obstetrics and Gynecology , 2013, DOI: 10.5455/2320-1770.ijrcog20130635
Abstract: 39 year old sterilized women presented like ruptured ectopic pregnancy with 40 days amenorrhea, pain, and shock Urine Pregnancy Test negative. Culdocentesis was positive. Ultra sonogram confirmed hemoperitoneum and TO mass. Laparotomy revealed left solid ovarian tumour with tumour mass protruding from perforated site and hemoperitoneum. Histological diagnosis was granulosa cell (GC) tumour Stage 1c. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000): 254-256]
Two Cases of Primary Ectopic Ovarian Pregnancy  [cached]
Sonia Gon,Bipasa Majumdar,Tanushree Ghosal,Mallika Sengupta
Online Journal of Health & Allied Sciences , 2011,
Abstract: Primary ovarian pregnancy is one of the rarest varieties of ectopic pregnancies. Patients frequently present with abdominal pain and menstrual irregularities. Intrauterine devices have evolved as probable risk factors. Preoperative diagnosis is challenging but transvaginal sonography has often been helpful. A diagnostic delay may lead to rupture, secondary implantation or operative difficulties. Therefore, awareness of this rare condition is important in reducing the associated risks. Here, we report two cases of primary ovarian pregnancies presenting with acute abdominal pain. Transabdominal ultrasonography failed to hint at ovarian pregnancy in one, while transvaginal sonography aided in the correct diagnosis of the other. Both cases were confirmed by histopathological examinations and were successfully managed by surgery.
Severe Ovarian Hyperstimulation Syndrome Coexisting with a Bilateral Ectopic Pregnancy.  [PDF]
Chii-Shinn Shiau,Ming-Yang Chang,Chi-Hsin Chiang,Ching-Chang Hsieh
Chang Gung Medical Journal , 2004,
Abstract: Management of severe ovarian hyperstimulation syndrome (OHSS) includes hospitalizationfor fluid and electrolyte management. Abdominal paracentesis is also used as minimallyinvasive form of management in selected cases of severe OHSS following ovulationinduction. However, if pregnancy ensues, the syndrome persists for a longer period, and theclinical manifestations of severe OHSS could mask the picture of a bleeding gestational sac.It could be easily overlooked unless the possibility of an ectopic pregnancy is kept in mindin cases of severe OHSS exacerbated by early pregnancy with or without a previous ectopicpregnancy history. We report a case of severe OHSS with simultaneous bilateral tubal pregnancyfollowing intrauterine insemination (IUI). A 31-year-old woman with polycystic ovariandisease developed severe OHSS during the therapeutic course of IUI. An emergentexploratory laparotomy was performed 14 days after admission, and the operative findingsshowed persistent profuse bleeding from the bilateral fimbrial ends with marked enlargementof the ampullary portions. A linear salpingotomy was performed by a longitudinal incisionalong the area of maximal distension of the dilated fallopian tubes to preserve her fertility.We recommend that in cases of severe OHSS exacerbated by early pregnancy, serialserum β-hCG and transvaginal ultrasound follow-up may be necessary due to the potentialassociation of severe OHSS in pregnancy with an ectopic pregnancy.
M. Bejenaru, ,,,Ioana Iftimie-Nastase,I. Gheju,M. Beuran
Jurnalul de Chirurgie , 2011,
Abstract: Ectopic ovarian pregnancy is rarely diagnosed, its incidence accounting for 0.3-3% of all ectopic pregnancies. Of late there has been an increase in the incidence of ovarian pregnancies due to better diagnostic modalities and certain risk factors. Here we report a case of ruptured ovarian pregnancy in a 35 year-old woman, missed initially due to a negative urine pregnancy test, which was successfully managed surgically.
Ovarian Ectopic Pregnancy: Association with Intrauterine Contraceptive Device  [cached]
Huseyin Cengiz,Cihan Kaya,Murat Ekin,Hakan Guraslan
Cukurova Medical Journal , 2013,
Abstract: Primary ovarian pregnancy is a rare entity. The association between ovarian pregnancy and intrauterine device use is not clear. In this paper we reported three patients with ovarian pregnancy and using intrauterine device with a brief review of the literature. [Cukurova Med J 2013; 38(3.000): 520-524]
Diagnosis and clinical approach in primary ovarian ectopic pregnancy: A case report and review of the literature  [PDF]
?zge Y?lmaz,Suna Kabil Kucur,Duygu Yard?m,?nci Davas
Dicle Medical Journal , 2013,
Abstract: Primary ovarian pregnancy is a rare type of extrauterinepregnancy with an incidence of 0.5-1% of all ectopic pregnancies.The incidence ranges from 1/40000 to 1/7000deliveries. We report a primary ovarian pregnancy in aspontaneus conception cycle in a 40-year-old womanwith no predisposing factor. The patient was admitted tothe emergency clinic with signs and symptoms of acuteabdomen with heamoperitoneum , in a preshock state. Anemergency laparotomy and wedge resection of the ovarywas performed. Histopathologic examination showedchorion villi embedded in the ovarian tissue in multiplesections in different areas of the material. This is a discussionabout this rare phenomenon, its ethiology, differentialand clinical diagnosis and a review of literature.Key words: Ectopic, pregnancy, ovary
Ovarian Pregnancy
A. Radotra, S. Malhotra, K. Kulshreshtha, H. Mohan
JK Science : Journal of Medical Education & Research , 2000,
Abstract: Ovarian pregnancy is a rare form of ectopic pregnancy. We present here a case of an ovarianprcgnancy. who presented to us as an acute abdomen.
Case Report of Ectopic Pregnancy during Controlled Ovarian Stimulation without Oocytes Harvested and Late Ovarian Hyperstimulation Syndrome  [PDF]
Hui Lin, Wen He, Jie Lv, Chanlin Han, Li Sun, Jianping Ou, Liuhong Cai
Advances in Reproductive Sciences (ARSci) , 2018, DOI: 10.4236/arsci.2018.63008
Abstract: Here we reported a rare case of misdiagnosed ectopic pregnancy (EP) due to unintended ovulation during controlled ovarian stimulation (COS) in GnRH agonist cycle, resulting in no oocytes harvested and late hyper-stimulation syndrome (OHSS). The patient was a 33-year old primary infertile woman due to male’s factors and underwent her second in vitro fertilization (IVF) cycle using GnRH agonist protocol, and no oocytes harvested on ovum picked-up (OPU) day. The start of gonadotropin usage was on day 8th of her period, and the P level increased rapidly and strangely high from day 8th after gonadotropin usage. The E2 level and follicles grew normally but finally no oocytes harvested. She was diagnosed as late ovarian hyper-stimulation syndrome (OHSS) 7 days after OPU. 20 days after OPU, no menstruation come and a positive urine test of hCG were reported. And the patient was diagnosed as EP by laparoscopy. In conclusion, rapidly increased P level, no oocyte retrieval and late onset of OHSS should be very important clues to diagnose this misdiagnosed EP.
Ovarian pregnancy presenting as ovarian tumour: Report of 2 cases  [cached]
Samaila MOA,Adesiyun A,Yusufu LMD
Annals of African Medicine , 2007,
Abstract: We present 2 cases of ovarian masses diagnosed as tumours but turned out to be pregnancy. Ovarian pregnancy, a form of ectopic gestation has a distinct pathology though it can be a source of diagnostic difficulty clinically and intraoperatively. A total of 71 ectopic pregnancies were seen in the department from January 2001 to December 2005, of these only two were ovarian ectopics. Both patients were nulliparous and presented with lower abdominal pains, abdominal masses and menstrual irregularity. They both had laparotomy and total right salpingo-oophorectomy. Grossly, the ovaries were enlarged, grey tan and globular. Focal ruptures in the wall of the ovaries showed protruding fetal parts. Microscopy showed chorionic villi within and in continuity with ovarian stroma and corpus luteum. They were both diagnosed ovarian ectopics. A good knowledge and understanding of the gross pathology, combination of imaging studies and high index of suspicion should help in making an intra-operative diagnosis.
Secondary abdominal pregnancy and its associated diagnostic and operative dilemma: three case reports
Pratiksha Gupta, Alka Sehgal, Anju Huria, Reeti Mehra
Journal of Medical Case Reports , 2009, DOI: 10.4076/1752-1947-3-7382
Abstract: Three cases are reported. All came from a lower middle-income group and all of them were subjected to surgery. The first patient was a 30-year-old woman, who was pregnant for the fourth time, who presented at 16 weeks with an abdominal pregnancy. She was admitted with constant abdominal pain and retention of urine. She was hemodynamically stable and was administered a pre-operative intramuscular injection of methotrexate. During laparotomy she had only minor blood loss, the major part of the placenta was removed easily and she did not require any blood transfusion. Serum beta human chorionic gonadotrophin values and ultrasound follow-up revealed a normal study four weeks after surgery. The second patient was a 26-year-old woman, pregnant for the third time, admitted at 14 weeks with an abdominal pregnancy with hemoperitoneum, and the third patient was a 24-year-old woman, pregnant for the first time, who presented at 36 weeks gestation. She was only diagnosed as having an abdominal pregnancy during surgery, experienced excessive blood loss and required a longer hospital stay.We hypothesize that treatment with pre-operative systemic methotrexate with subsequent laparotomy for removal of the fetus and placenta may minimize potential blood loss, and would be a reasonable approach in the care of a patient with an abdominal pregnancy with placental implantation to the abdominal viscera and blood vessels. This treatment option should be considered in the management of this potentially life-threatening condition. During surgery, if the placenta is attached to vital organs it should be left behind. Early diagnosis can help in reducing associated maternal morbidity and mortality.Abdominal pregnancy has historically been defined as an implantation in the peritoneal cavity, exclusive of tubal, ovarian or intraligamentary pregnancy [1]. Abdominal pregnancy is a rare obstetric complication with high maternal mortality and even higher perinatal mortality, and it can be primary or
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