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

Abstract

Ovarian ectopic is a rare form of ectopic pregnancy and reaching up to term is an extreme rarity. It is usually diagnosed incidentally when a cesarean section is done for other obstetric causes. Being highly vascular, it may result in obstetric catastrophes. We report first live post-term ovarian pregnancy well managed with multidisciplinary approach. A 35-year multigravida at 44 weeks presented with a diagnosis of placenta percreta. Magnetic resonance imaging suggested abdominal pregnancy with a live fetus. On laparotomy, it was live ovarian ectopic with placenta attached to left infundibulopelvic vessels and later confirmed on histological examination. Ovarian ectopic is best diagnosed in the first trimester by ultrasound and managed by laparoscopy or laparotomy. It is usually misdiagnosed as an abdominal pregnancy at term even with the use of high-end technology. It always poses a dilemma for clinicians. Preoperative magnetic resonance imaging helps in the planning of surgery with all precautionary measures and counseling of patients.

Ovarian Pregnancy: A Systematic Review and 2 Case Reports

“…Adnexectomies instead of conservative surgery were performed in 30%, 6%, 41% and 78% respectively. Not surprisingly women in shock had more adnexectomies (P<0.0001) In 2 women a hysterectomy was performed (1.8%), one with a gestation of 44 weeks with the placenta involving the uterus (37), and one in a 45 years old lady (38). Follow-up after surgery was uneventful in all except in 1 woman in whom medical treatment was given because an HCG of 2134 IU/ml suggested residual trophoblastic tissue (39).…”