A 34-week ovarian pregnancy: case report and review of the literature

Abstract

Advanced ovarian pregnancy is a quite rare condition. Due to the high maternal and neonatal mortality rates, early and accurate diagnosis is vital. Lack of sufficient data led us to search the literature and compile available data on the topic. A 33-year-old woman presented with acute abdomen at 34 weeks of gestation. She underwent laparotomy, which revealed a live foetus surrounded by an intact amnion membrane located in the left adnexal area. The patient delivered a live female infant. Heavy bleeding from the placenta necessitated salpingo oophorectomy. Histological examination of the removed tissue confirmed the ovarian pregnancy. Because of the substantial risk of adverse outcomes, this condition should be borne in mind, especially in cases presenting with acute abdomen during pregnancy. (J Turkish-German Gynecol Assoc 2013; 14: 246-9) Key words: Abdominal pregnancy, ectopic pregnancy, ovarian pregnancy Received: 06 November, 2012 Accepted: 23 January, 2013 Available Online Date: 10 July, 2013 İkinci ve üçüncü trimester over gebeliği oldukça nadir bir durumdur. Yüksek maternal ve neonatal mortalite oranları nedeniyle erken ve doğru tanı konulması hayat kurtarıcıdır. Karşılaştığımız ender rastlanan olgu ve konu ile ilgili yeterli bilginin bulunmayışı bizi ikinci ve üçüncü trimester over gebeliği hakkındaki literatürü irdelemeye yöneltti. Otuz üç yaşında kadın hasta, gebeliğin otuz dördüncü haftasında akut abdomen bulgularıyla kliniğimize başvurdu. Laparatomide sol adneksial alanda intakt amniotik membran ile çevrili, içinde canlı fetusun bulunduğu ekstrauterin gebelik tespit edildi. Canlı bir kız bebek doğurtuldu. Plasental alandaki şiddetli kanama nedeniyle salpingo ooferektomi yapıldı. Histopatolojik sonuç over gebeliğiyle uyumlu bulundu. Özellikle ilk trimesterden sonra akut batın bulgularıyla başvuran hastalarda, ayırıcı tanıda over gebeliği akılda tutulmalıdır.

Embarazo abdominal avanzado con feto vivo. Reporte de un caso y revisión de la literatura

“…Los objetivos principales incluyen la extracción del feto y una adecuada evaluación y manejo de la implantación vascular y placentaria (2). La extracción de un feto vivo a término es rara, con pocos casos publicados en la literatura (7,20,21).…”

Successful outcome in a rare case of live post‐term ovarian pregnancy

“…[2][3][4] It is more common in developing countries as contributing risk factors are similar to tubal ectopic that is, tubal surgeries, pelvic inflammatory disease, infections and use of intrauterine device. [2][3][4][5][6][7] Although the ovary is more expansible than the fallopian tube, still first-trimester rupture (75%) is the usual course. 5,8 It is very rare that ovarian ectopic pregnancy advances and even more rare to get it at term.…”

“…5,8 It is very rare that ovarian ectopic pregnancy advances and even more rare to get it at term. 5,6,8,9 At advanced gestation, it is usually misdiagnosed as abdominal pregnancy. Thus, term ovarian pregnancy is a rarity and the baby is a 'miracle baby'.…”

Diagnosis of abdominal pregnancy still a challenge in low resource settings: a case report on advanced abdominal pregnancy at a tertiary facility in Western Kenya

“…Advanced abdominal pregnancy can be discovered during elective Cesarean section [4]. Few cases of fetal survival have been reported though rare [5]. Advanced abdominal pregnancy is associated with high mortality rate for both the mother and the baby at 1-20 % and 40-95% respectively [6].…”