Ovarian ectopic pregnancy: Aetiology, diagnosis, and challenges in surgical management

Abstract

Primary ovarian ectopic pregnancy (OEP) remains a rare but important type of ectopic pregnancy which is normally diagnosed at surgery. The aetiology is unknown. We have found fertility treatments (18.1%) and intrauterine contraceptive devices (19.3%) remain important associated risk factors. We undertook a world literature review of all cases since 1995. We found that 52% of cases were managed laparoscopically, which is less than the reported UK rate of all ectopics, of 85.9%. Over that time period, eight patients were treated medically with a success rate of 50%. While the original 1878 Spiegelberg's criterion still holds for the diagnosis, the addition of modern ultrasound scanning has made a radiological diagnosis possible. In a few cases, the management of OEP remains similar to that of a tubal ectopic pregnancy with the same challenges. Laparoscopy with ovarian sparing in the stable woman is today the surgical treatment of choice.

Keywords::

• Gynaecological surgery
• ovarian ectopic pregnancy
• surgical techniques

Acknowledgements

This paper was partly funded by the Watford Gynaecological Research Fund (WGRF). We also acknowledge the support of the ectopic foundation (EPF) Registered charity no. 1122286 (www.ectopicpregnancy.co.uk).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.