Ovarian Pregnancy: A Series of 24 Cases

Abstract

This study was undertaken to investigate 24 cases of ovarian pregnancy identified by retrospective analysis of 148,734 deliveries at 6 hospitals between 1952 and 1980, and to review pertinent literature. Although ovarian pregnancy is rare, it was shown to occur 4 times more frequently than previously believed—on the order of 1 per 7000 deliveries and slightly less than 3% of all ectopic pregnancies. Awareness of the possibility of ovarian pregnancy and closer histologic examination of surgical specimens are critical factors for increased recognition. The use of intrauterine contraceptive devices was not associated with an absolute increase in occurrence of ovarian pregnancy. More than half the cases involved a history of previous reproductive system pathology or infertility. Clinical presentations of ovarian and tubal pregnancies are similar and differentiation can be made only after microscopic examination of tissue specimens. Even then, diagnosis of primary ovarian pregnancy may be elusive due to increasing tissue destruction and greater use of conservative surgical procedures. When the diagnosis of ectopic pregnancy is being considered, an organized diagnostic approach should be followed. Culdocentesis should be performed whenever hemoperitoneum is suspected. The preferred therapeutic procedure is ovarian cystectomy or ovarian wedge resection. No maternal mortality occurred in any of the cases reviewed. An extremely rare case of ovarian pregnancy following vaginal hysterectomy is presented.