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OUT OF PLACE: A Case Report of Ovarian Pregnancy

Socorro Caguiat, Patricia Nevira V. Suarez

 The incidence of ovarian ectopic pregnancy is 1 in 7,000 to 40,000, but most rupture in the first trimester and only a few survive to term (Lee, et al.). An untreated ovarian pregnancy is a medical emergency as it may cause fatal intraabdominal bleeding. This paper reports a rare case of a term unruptured ovarian pregnancy in a 23-year-old Gravida 2 Para 1 (1-0-0-1) at 40 weeks and 6 days age of gestation. Previous ultrasound revealed an intrauterine pregnancy in breech presentation and abdominal delivery for malpresentation was planned. Intra-operatively, there was a left adnexal mass measuring 30 x 30 cm, posterior to the uterus. Abdominal pregnancy was considered. The baby was delivered alive. On further inspection, the placenta was noted at the left inferior part of the capsule, seemingly implanted on the left adnexal area. Bleeding was also noted, which was thought to result from detachment of the placenta. Failure to control the bleeding subsequently led to the removal of the mass, with ligation of the left infundibulopelvic ligament, sigmoid artery feeding vessels, and left uterotubal portion. Post-operatively, the patient had stable vital signs. The wound was closely monitored for signs of infection or dehiscence. She was subsequently discharged on her sixth post-operative day and was seen at the out-patient department for post-operative care.