Primary Ovarian Pregnancy
Vorapong Phupong, MD*, Pornthip Ultchaswadi, MD*
Affiliation : * Private Clinic, Nonthaburi
Background : Primary ovarian pregnancy is a relatively rare form of ectopic pregnancy with an incidence of
1/6,000-1/40,000 pregnancies.
Case Report : A 25-year-old woman, gravida 1, parity 0, presented with vaginal bleeding after 8 weeks of
amenorrhea. Pelvic examination revealed a left adnexal mass and transvaginal ultrasound confirmed a left
adnexal echocomplex mass with free fluid in the cul-de-sac. Serum β hCG was 3,441 mIU/mL. Emergency
exploratory laparotomy was performed with a preoperative diagnosis of left ectopic pregnancy, suspected of
ovarian pregnancy. Ruptured left ovarian pregnancy was intraoperatively diagnosed. Left salpingo-oophorec-
tomy was performed. The histopathology confirmed ovarian pregnancy. She was well at discharge and
throughout a 4-week period of follow-up.
Conclusion : Although primary ovarian pregnancy is rare and difficult to diagnose clinically and even
intraoperatively, it can be detected early with the use of combined transvaginal ultrasonography and serum
β hCG. The standard of care is conservative treatment in order to preserve the patient’s fertility.
Keywords : Ectopic pregnancy, Ovarian pregnancy, Primary
