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Federación Mexicana de Ginecología y Obstetricia, A.C.

2025, Number 2

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Ginecol Obstet Mex 2025; 93 (2)

Experience in ectopic pregnancy implanted in the ovary: case series

Miranda FAF

Language: Spanish
References: 22
Page: 57-63
PDF size: 303.59 Kb.


ABSTRACT

Objective: To describe the experience of the Instituto Nacional Materno Perinatal in Lima, Peru, in the management of patients with an ectopic pregnancy implanted in the ovary.
Materials and Methods: Observational, descriptive and retrospective case series study carried out on patients diagnosed with an ectopic pregnancy implanted in the ovary who were treated between 2021 and 2023 at the Instituto Nacional Materno Perinatal, Lima, Peru. The diagnosis was suspected on the basis of clinical symptoms and the beta fraction of human chorionic gonadotropin hormone (β-hCG), and was confirmed by transvaginal ultrasound and histopathology.
Results: 480 ectopic pregnancies were recorded, of which 6 cases were found to be ectopic pregnancies implanted in the ovary, representing 1.25%. The mean age of the patients was 30 years (range from 23 to 39 years). Four of the patients were primigravidae and the majority had no risk factors, only two had a history of previous cesarean section. The mean gestational age was 6.6 weeks. Abdominal pain associated with transvaginal bleeding was the most common clinical presentation. The mean initial b-hCG was 15242.3 mU/mL. The mean size of the ectopic mass was 45.3 mm.
Conclusion: Ectopic pregnancy is an uncommon complication of ovarian pathology, but with a high risk of massive hemorrhage if not diagnosed in time. Its diagnosis is challenging and is often made during surgery after rupture and the resulting acute abdomen. Treatment remains surgical, and in recent years wedge resection has become an important option to preserve as much healthy ovarian tissue as possible.


REFERENCES

  1. Almahloul Z, Amro B, Nagshabandi Z, Alkiumi I, et al. Ovarianpregnancy: 2 case reports and a systematic review. J ClinMed 2023 ;12 (3): 1138. https://doi:10.3390/jcm12031138

  2. ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy.Obstetrics and Gynecology 2018; 131 (3): e91-e103.https://doi:10.1097/AOG.0000000000002464

  3. Thanasa E, Thanasas I, Koutalia N, Mousia M. Surgicaltreatment of ovarian pregnancy. Case Rep Obstet Gynecol.2021; 2021:6618751. https://doi:10.1155/2021/6618751

  4. Tapia A, Méndez P, Inca P, Cruz Z, et al. Embarazo ectópicoovárico: reporte de un caso y revisión de la literatura. AVFT2020; 39 (4): 256-259. doi.org/10.5281/zenodo.4087997

  5. Li H, Liu Y, Yang Y, Zhao X, et al. Clinical analysis of womenwith ovarian pregnancy: a retrospective case-controlstudy. BMC Pregnancy Childbirth 2022; 22: 768. https://doi.org/10.1186/s12884-022-05099-8

  6. Zoukar O, Zouari I, Jemaa Y, Aissa R, et al. La grossesseovarienne à propos d’un cas et revue de la littérature.Pan Afr Med J 2021; 40: 208. https://doi:10.11604/pamj.2021.40.208.32011

  7. Seo MR, Choi JS, Bae J, Lee WM, et al. Preoperative diagnosticclues to ovarian pregnancy: retrospective chartreview of women with ovarian and tubal pregnancy. ObstetGynecol Sci 2017; 60 (5): 462-68. https://doi:10.5468/ogs.2017.60.5.462

  8. Ren F, Liu G, Wang T, Li M, et al. Unruptured ovarian ectopicpregnancy: Two case reports and literature review.Front. Physiol 2022; 13: 1036365. https://doi:10.3389/fphys.2022.1036365

  9. Aydin T, Yucel B, Aksoy H, Ekemen S. Successful laparoscopicmanagement of a rare complication after embryo transfer:ovarian pregnancy. A case report and up-to-date literaturereview. Wideochir Inne Tech Maloinwazyjne 2016; 10 (4):574-9. https://pubmed.ncbi.nlm.nih.gov/26865895/

  10. Odejinmi F, Rizzuto MI, Macrae R, Olowu O, Hussain M.Diagnosis and laparoscopic management of 12 consecutivecases of ovarian pregnancy and review of literature.J Minim Invasive Gynecol. 2009;16(3):354-9. https://doi:10.1016/j.jmig.2009.01.002

  11. Ko PC, Lo LM, Hsieh TT, Cheng PJ. Twenty-one years ofexperience with ovarian ectopic pregnancy at one institutionin Taiwan. Int J Gynaecol Obstet 2012;119 (2): 154-8.https://doi:10.1016/j.ijgo.2012.06.008

  12. Choi HJ, Im KS, Jung HJ, Lim KT, et al. Clinical analysis ofovarian pregnancy: a report of 49 cases. Eur J Obstet GynecolReprod Biol 2011; 158 (1): 87-9. https://doi:10.1016/j.ejogrb.2011.04.015

  13. Raziel A, Schachter M, Mordechai E, Friedler S, et al. Ovarianpregnancy-a 12-year experience of 19 cases in oneinstitution. Eur J Obstet Gynecol Reprod Biol 2004; 114 (1):92-6. https://doi:10.1016/j.ejogrb.2003.09.038

  14. Goyal LD, Tondon R, Goel P, Sehgal A. Ovarian ectopicpregnancy: A 10 years' experience and review of literature.Iran J Reprod Med 2014; 12 (12): 825-30.

  15. Begum J, Pallavee P, Samal S. Diagnostic dilemma in ovarianpregnancy: a case series. J Clin Diagn Res. 2015;9(4): QR01-3. https://doi:10.7860/JCDR/2015/11501.5772

  16. Zhu Q, Li C, Zhao W, Yuan J, et al. Risk factors and clinicalfeatures of ovarian pregnancy: a case-control study. BMJOpen 2014; 4 (12): e006447. https://doi:10.1136/bmjopen-2014-006447

  17. González B, Salas B, Hernández G, De Santiago G. Embarazoectópico ovárico: experiencia en 10 años del HospitalUniversitario La Paz, Madrid, España. 2012; 77 (1): 50-54.http://dx.doi.org/10.4067/S0717-75262012000100010.

  18. Kasraei S, Seifollahi A, Aghajani F, Nakhostin A, et al. Successfulmanagement of a patient with ovarian ectopicpregnancy by the end of the first trimester: a case report. JMed Case Reports 2022; 16: 175. https://doi.org/10.1186/s13256-022-03403-w

  19. Sánchez GP, Sancho SB, Pedro-Viejo GG. Embarazoectópico ovárico. Prog Obstet Ginecol 2017; 60 (4):359-62. https://ibecs.isciii.es/cgi-bin/wxislind.exe/iah/online/?IsisScript=iah/iah.xis&src=google&base=IBECS&lang=e&nextAction=lnk&exprSearch=165803&indexSearch=ID

  20. Pagidas K, Frishman GN. Nonsurgical management of primaryovarian pregnancy with transvaginal ultrasound-guided localadministration of methotrexate. J Minim Invasive Gynecol2013; 20 (2): 252-54. https://doi:10.1016/j.jmig.2012.10.012

  21. Pato-Mosquera M, Castro-Villar L, Borrajo-Hernández E,Araújo-Fernández JE. Embarazo ectópico ovárico. ProgObstet Ginecol 2013; 56 (5): 266-269. https://dx.doi.org/10.1016/j.pog.2012.07.013

  22. Zeevi G, Bercovich O, Haring Y, et al. Nomogram to predictmethotrexate treatment success in ectopic pregnancy. IntJ Gynecol Obstet 2024; 168: 620-27. https://doi:10.1002/ijgo.15927




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