Ovarian ectopic pregnancy: a review article

  • Dr. Pragati Meena Department of Obstetrics Gynecology, NIMS Medical College and Hospital, Shobha Nagar, Delhi Highway Jaipur, Rajasthan, India
  • Dr. Poonam Bhojwani Department of Obstetrics Gynecology, NIMS Medical College and Hospital, Shobha Nagar, Delhi Highway Jaipur, Rajasthan, India
  • Dr. Gajendra Singh Verma Department of Obstetrics Gynecology, NIMS Medical College and Hospital, Shobha Nagar, Delhi Highway Jaipur, Rajasthan, India
Keywords: Ectopic pregnancy, Laparotomy, Salpingoophorectomy, Methotrexate

Abstract

Ectopic pregnancy is a major health issue in reproductive age group female. Incidence of primary ovarian ectopic pregnancy as mentioned in literature of India is variable from 0.001% to 0.014% of normal pregnancies. Only 0.15% to 3.0% of all ectopic pregnancy occurs in ovary and it is 2ndmost common site of ectopic pregnancy after fallopian tube. Annual incidence of extra uterine cavity pregnancy is rising over past 3 yrs. The aim of ourpresent study isto find out the incidence of ovarian ectopic pregnancy, role of USG in pre-operative diagnosisand risk factors, feasibility of conservative management with medical method or conservative management e.g. minimal invasive surgery in developing countries like India. We analysed the incidence, management of ovarian pregnancy & reviewed the literature, risk factors and clinical presentation of ovarian ectopic pregnancies managed at NIMS Medical College and Hospital jaipur. According to Spielberg criteria, it is a diagnostic challenge to obstetrician. Diagnosis of ectopic pregnancy can be missed radio logically and intra operatively. It Should be suspected in patients presented with rupturedectopic pregnancy, ultrasound features suggestive of normal bilateralfallopian tube with hemo peritoneum with breached ovarian surface. Conservative surgical approach is preferred, now days Medical management is preferred for unruptured ectopic pregnancy. Confirmation of ovarian pregnancy done only after histopathological report. Now daysMedical management with single dose of Methotrexate is very successful for un ruptured ovarian pregnancy

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References

1. Joseph RJ, Irvine LM. Ovarian ectopic pregnancy: aetiology, diagnosis, and challenges in surgical management. J Obstet Gynaecol. 2012 Jul;32(5):472-4. doi: 10.3109/01443615.2012.673039.

2. Mehmood SA, Thomas JA. Primary ectopic ovarian pregnancy (report of three cases). J Postgrad Med 1985;31: 219.

3. Rana P, Kazmi I, Singh R, Afzal M, Al-Abbasi FA, Aseeri A, Singh R, Khan R, Anwar F. Ectopic pregnancy: a review. Arch Gynecol Obstet. 2013 Oct;288(4):747-57. doi:
10.1007/s00404-013-2929-2. Epub 2013 Jun 21. [PubMed]

4. Krik E, Bourne T . Ectopic pregnancy. Obstet gynecol Reprod Med 2011;21(7):207-211,2011.

5. Goyal Lajya Devi, Tondon Rimpy, Goel Poonam and Sehgal Alka . Ovarian ectopic pregnancy: A 10 years’ experience and review of literature. Iran J Reprod Med. 2014 December; 12(12): 825–830.

6. Fritz MA, Speroff L. Clinical gynecologic endocrinology and infertility, 8th edn. Wolters Kluwer Health/Lippincott Williams & Wilkins, Philadelphia.2011.

7. Hallatt JG. Primary ovarian pregnancy: a report of twenty-five cases. Am J Obstet Gynecol. 1982;143:55–60. PMID: 7081312.doi.org/10.1016/0002-9378(90)90685-Z.

8. Panelli Danielle M , H. Phillips Catherine , Brady Paula C. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review. Fertility Research and Practice 2015; 1:15,2015. DOI:10.1186/s40738-015-0008.

9. Vanitha N Sivalingam,W Colin Duncan; Emma Kirk, Lucy A Shephard, Andrew W Horne. Diagnosis and Management of Ectopic Pregnancy. J Fam Plann Reprod Health Care. 2011;37(4):231-240,2011. doi:10.1136/jfprhc-2011-0073.

10. Comstock C, Huston K, Lee W. The ultrasonographicappearance of ovarianectopic pregnancies. Obstet Gynecol. 2005 Jan;105(1):42-5.

11. Chang FW, Chen CH, Liu JY. Early diagnosis of ovarian pregnancy by ultrasound. Int J Gynecol Obstet. 2004;85:186–187.

12. Juan YC, Wang PH, Chen CH, Ma PC, Liu WM. Successful treatment of ovarian pregnancy with laparoscopy-assisted local injection of etoposide. Fertil Steril . 2008;90:1200.

13. Mittal S, Dadhwal V, Baurasi P. Successful medical management of ovarian pregnancy. Int J Gynecol Obstet . 2003;80:309–310. [PubMed]

14. Buster JE, Carson SA. Ectopic pregnancy: newadvances in diagnosis and treatment. Curr Opin Obstet Gynecol. 1995 Jun;7(3):168-76.

15. Gabbur N, Sherer DM, Hellmann M . Do serum beta-human chorionic gonadotropin levels on day 4 following methotrexate treatment of patients with ectopic pregnancy predict successful single-dose therapy? Am J Perinatol.2006. 23:193–196. [PubMed]

16. Barnhart KT, Gosman G, Ashby R, Sammel M. The medicalmanagement of ectopic pregnancy: a meta-analysiscomparing "single dose" and "multidose" regimens.Obstet Gynecol. 2003 Apr;101(4):778-84.

17. Barnhart K, Hummel AC, Sammel MD, Menon S, Jain J, Chakhtoura N. Use of "2-dose" regimen of methotrexate to treat ectopic pregnancy. Fertil Steril. 2007 Feb;87(2):250-6. Epub 2006 Nov 13. [PubMed]

18. Hamed HO, Ahmed SR, Alghasham AA. Comparison of double- and single-dosemethotrexateprotocols for treatment of ectopic pregnancy. Int J Gynaecol Obstet. 2012 Jan;116(1):67-71. doi: 10.1016/j.ijgo.2011.08.009. Epub 2011 Oct 28.

19. Kirk E, Condous G, Van Calster B, Haider Z, Van Huffel S, Timmerman D, Bourne T. A validation of the most commonly used protocol to predict the success of single-dose methotrexate in the treatment of ectopic pregnancy. Hum Reprod. 2007 Mar;22(3):858-63. Epub 2006 Nov 6. [PubMed]

20. Bagga R, Suri V, Verma P, Chopra S, Kalra J. Failed Medical Management in Ovarian Pregnancy Despite Favorable Prognostic Factors-A Case Report. Med Gen Med. 2006;8:35.PMID:16926774.

21. Habbu J, Read MD. Ovarian pregnancy successfully treated with methotrexate. J Obstet Gynaecol. 2006 Aug;26(6):587-8. [PubMed]

22. Shapiro HI, Adler DH. Excision of an ectopic pregnancy through the laparoscope. Am J Obstet Gynecol. 1973;117:290–1. PMID: 4269637. [PubMed]

23. Ayakannu T, Rogers J, Wordsworth S, Jayagopal N, Vine S. Conservative laparoscopic approach with systemic medical management of an ovarianectopic gestation. J Obstet Gynaecol. 2007;27:449–50.https://doi.org/10.1080/01443610701360009.

24. Mittal S, Dadhwal V, Baurasi P. Successful medical management of ovarian pregnancy. Int J Gynaecol Obstet. 2003 Mar;80(3):309-10. [PubMed]

25. O. Birge, M. M. Erkan, E. G. Ozbey, and D. Arslan. Medical management of an ovarian ectopic pregnancy: a case report. Journal of Medical Case Reports. , 2015; vol. 9:1, article no. 774.

26. G. Scutiero, P. Di Gioia, A. Spada, and P. Greco. Primary ovarian pregnancy and its management,” Journal of the Society of Laparo-endoscopic Surgeons.2012 ; vol. 16:3,492–494. [PubMed]

27. Y. Koo, H. Choi, K. Im, H. Jung, and Y. Kwon. Pregnancy outcomes after surgical treatment of ovarian pregnancy. International Journal of Gynecology & Obstetrics.2011;vol. 114:,97–100,2011.

28. Chatburn Luke, Sanghani Reesha , Chatburn Luke, et al. An Alternative Treatment for the Ovarian Ectopic Pregnancy. J Womens Health Gyn.2015;Vol2: 102.

29. Odejinmi F, Rizzuto MI, Macrae R, Olowu O, Hussain M. Diagnosis and laparoscopicmanagement of 12consecutivecases of ovarian pregnancy and review of literature. J Minim Invasive Gynecol. 2009 May-Jun;16(3):354-9. doi: 10.1016/j.jmig.2009.01.002. [PubMed]

30. Nadarajah S, Sim LN, Loh SF. Laparoscopic management of an ovarian pregnancy. Singapore Med J. 2002 Feb;43(2):095-6.
Ovarian ectopic pregnancy: a review article
CITATION
DOI: 10.17511/joog.2017.i04.06
Published: 2017-12-31
How to Cite
Meena, P., Bhojwani, P., & Singh Verma, G. (2017). Ovarian ectopic pregnancy: a review article. Obs Gyne Review: Journal of Obstetric and Gynecology, 3(4), 63 70. https://doi.org/10.17511/joog.2017.i04.06
Section
Review Article