ovarian pregnancy

Ovarian pregnancies are dangerous and prone to internal bleeding.

Patients with an ovarian pregnancy have a good prognosis for future fertility and therefore conservative surgical management is advocated.

An untreated ovarian pregnancy causes potentially fatal intraabdominal bleeding and thus may become a medical emergency.

The oviduct on the affected side is intact (this criterion, however, holds not true for a longer ongoing ovarian pregnancy).

Ovarian pregnancy refers to an ectopic pregnancy that is located in the ovary.

Some have suggested that patients who undergo IVF therapy are at higher risk for ovarian pregnancy.

An 'ovarian pregnancy' is differentiated from a tubal pregnancy by the Spiegelberg criteria.

Because of the proximity of the tube, the sonographic distinction between a tubal and an ovarian pregnancy may be difficult.

Ovarian pregnancies have been successfully treated with methotrexate since it was introduced in the management of ectopic pregnancy in 1988.

An ovarian pregnancy can be mistaken for a tubal pregnancy or a hemorrhagic ovarian cyst or corpus luteum prior to surgery.

Traditionally, an explorative laparotomy was performed, and once the ovarian pregnancy was identified, an oophorectomy or salpingo-oophorectomy was performed, including the removal of the pregnancy.

Ovarian pregnancies are rare: the vast majority of ectopic pregnancies occur in the fallopian tube; only about 0.15-3% of ectopics occur in the ovary.

Ovarian pregnancies rarely go longer than 4 weeks; nevertheless, there is the possibility that the trophoblast finds further support outside the ovary and thus may affect the tube and other organs.

An ovarian pregnancy can develop together with a normal intrauterine pregnancy; such a heterotopic pregnancy will call for expert management as not to endanger the intrauterine pregnancy.

Sometimes, only the presence of trophoblastic tissue during the histologic examination of material of a bleeding ovarian cyst shows that an ovarian pregnancy was the cause of the bleeding.

The etiology of ovarian pregnancy is unknown, specifically as the usual causative factors - pelvic inflammatory disease and pelvic surgery - implicated in tubal ectopic pregnancy seem to be uninvolved.

There appears to be a link to the intrauterine device (IUD), however, it cannot be concluded that this is causative as it could be that IUDs prevent other but not ovarian pregnancies.