OVARIAN ECTOPIC PREGNANCY: AN UNUSUAL PRESENTATION AND TREATMENT

Date

2013-04-12

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Spring-Robbins, Chandra

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Abstract

Purpose: The purpose of this case report is to share a case of ovarian ectopic pregnancy and its complicated management. Ovarian ectopic pregnancies are rare, with an incidence of 1/7000 pregnancies. Management needs to consider future childbearing, ovarian preservation and hemodynamic stability. Methods: Involved a retrospective chart review of the management of a patient with a ruptured ovarian ectopic pregnancy. A literature review was undertaken for management points. Results: A 39 year old gravida 2, para 0102 presented to the Emergency Department and was diagnosed with likely hemoperitoneum and possible rupturing ectopic pregnancy. She was taken to the operating room and an ovarian ectopic noted laparoscopically and confirmed by pathologist on frozen section. An ovarian wedge resection performed and patient discharged home. She had persistently elevated human chorionic gonadotropin (hCG) level and was given methotrexate for presumed microscopically remaining chorionic villi. Her hormone level eventually declined to zero. Conclusions: Ovarian ectopic pregnancies are much more rare than those in the fallopian tubes. The management of them can be complicated by desire for ovarian preservation, significant hemoperitoneum if ruptured and persistent chorionic villi if the ovary is left behind.

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