Combination of ovarian and uterine pregnancy

The combination of uterine and ectopic pregnancy is not uncommon. Ovarian pregnancy is one of the most rare forms of ectopic pregnancy.

Ovarian pregnancy

Ovarian pregnancy is the rarest form of ectopic pregnancy.

OVARIAN ECTOPIC PREGNANCY- A RARE CASE REPORT

Background:Ovarian pregnancy is classified as a rare cause of non tubal pregnancy wherein maximum ends in rupture in early months of pregnancy. Sign and symptoms often mimic tubal rupture. To distinguish between the two based on presenting complaints and ultrasonography findings is difficult. Generally confirmation of ovarian preganancy is done only after histopathological examination due to its similarity in presenting complaints to tubal pregnancy. Medical management has also been tried for unruptured ectopic pregnancy. Case:Presenting a rare case report of ruptured left ovarian pregnancy. pt was 26yrs old multiparous with previous two cesarean 7yrs and 4 yrs back with one MTP kit taken 6 months back with pain in left iliac fossa. USG findings were suggestive of tubal rupture, however during laparotomy ruptured left ovarian pregnancy was diagnosed followed by left oopherectomy later on confirmed by histopathological examination.

Silent primary ovarian ectopic pregnancy following ovulation induction: diagnostic dilemma

Early diagnosis of an ovarian pregnancy, of all the diagnoses relating to extrauterine gestations, is perhaps a diagnostic challenge faced by an obstetrician and a radiologist. About 0.5% of extrauterine implantations occur in the ovary. Recent studies have demonstrated infertility and Assisted reproductive techniques (ARTs), multiparity, use of intrauterine devices as risk factors for ovarian ectopic. Knowledge pertaining to ovulation induction and risk of ovarian ectopic is even more scant. In this article, we report a case report of ovarian pregnancy following ovulation induction with letrozole. Patient visited with history of missed menstrual period, mild abdominal pain and a weakly positive urine pregnancy test. Provisional diagnosis of right tubal ectopic was made. Diagnosis of ruptured ovarian ectopic was made on explorative laparoscopy which was later confirmed histopathologically. Patient had normal intra and post-operative course. An ovarian ectopic can present as a life-threatening condition and a high index of suspicion can prevent morbidity as well as mortality. Ovarian pregnancy in a primigravida with ovulation induction without an alarming sign, as in this case, is the rarest entity came across till date.

On the question of rare forms of ectopic pregnancy (graviditas fimbrialis and graviditas interstitialis)

From the point of view of the mechanical theory explaining the occurrence of an ectopic pregnancy by a violation of the transport of the egg cell, the first stage where an ectopic inoculation of an egg can occur will be the inner surface of the follicle itself, in which this egg has matured. The possibility of such an intrafollicular ovarian pregnancy has been proven by the well-known case of C. van Tussenbroeck1) and recently confirmed by the observation of Hoehne2). In such cases, the release of the egg from the follicle cavity does not occur at all.