Ruptured primary ovarian pregnancy: a rare cause of haemoperitoneum - two case reports and review of literature

Abstract

Primary ovarian ectopic pregnancy remains a rare type of ectopic pregnancy which is normally diagnosed at surgery. Preoperative diagnosis by ultrasound is difficult, though now is being reported. Intraoperative diagnosis of ovarian pregnancy is difficult, as it can be confused with bleeding corpus luteum. The etiology of ovarian pregnancy is unknown. Fertility treatments and intrauterine contraceptive devices remain important associated risk factors Medical management and laparoscopy in unruptured cases can conserve ovary but ruptured ectopic still report in causality of government hospital. Two case reports are discussed. Both patients presented with ruptured ovarian ectopic needing laparotomy. There was no history of IUCD use or fertility treatment in either of them. Preoperative ultrasound in both patients was suggestive of ruptured tubal ectopic. Both were only diagnosed intraoperatively and met speigelberg criteria. A review of the literature, the specific symptoms, diagnostic criteria, and treatment of primary ovarian ectopic is discussed. Ovarian conservation should remain the aim in ovarian ectopic. However, cases with advanced gestation with massive haemoperitoneum can make ovarian conservation difficult. Early diagnosis in unruptured ovarian ectopic can conserve ovary.