Primary unruptured ovarian pregnancy with intrauterine device.

A case of intrafollicular and unruptured ovarian pregnancy associated with intrauterine device which meets the rigid criteria of Spiegelberg (1878) is presented. Clinically, unruptured cases can be confused with ovarian cysts. Intrauterine devices are highly effective for protection against uterine gestation and to a lesser degree against tubal gestation, but they have no effect in preventing ovarian gestation.     

Primary ovarian pregnancy. Report of fifteen cases.

From June 1973 through November 1988, fifteen cases of ovarian pregnancy were admitted to the Shanghai First People's Hospital. All these cases met the four criteria for the diagnosis as listed by Spiegelberg. The incidence of ovarian pregnancy as compared to those of normal and ectopic pregnancy are 1:3 179 and 1:28.1, respectively, which are higher than foreign data reported. Ovarian pregnancy is quite similar to tubal pregnancy in clinical manifestations. Etiological analysis does not reveal any close relationship with inflammation of the female genital tract. However, application of IUD increases the risk of ovarian pregnancy. The principle of management is wedge resection of the diseased ovary.

     

Primary ovarian leiomyoma

Ovarian leiomyoma is a rare and incidentally detected neoplasm, clinically indistinguishable from subserous leiomyomas and ovarian fibromas, until histopathological confirmation. We present a case of leiomyoma arising primarily from the ovary in a 35 year old woman.     

Primary omental pregnancy

Omental pregnancy is a rare form of ectopic pregnancy, and can be seen primarily or secondary to a tubal pregnancy. A 25-year-old woman presented with abdominal distention with pain and anemia without vaginal bleeding. After a provisional diagnosis of ruptured ectopic pregnancy, laparotomy was performed. On surgical exploration, the bilateral tubes and ovaries were intact, however, an omental pregnancy was detected as the cause of hemoperitoneum. Partial omentectomy was performed. Although most cases are secondary, presented here is an additional case of primary omental pregnancy at 12 weeks according to Studdiford's criteria. Histological evidence of neovascularization into the supporting tissue confirmed our diagnosis. A primary omental pregnancy should always be considered as a possible explanation for severe hemoperitoneum in ectopic pregnancies presenting with acute abdomen, and with intact adnexes on surgical exploration.     

Primary hepatic pregnancy

A case of a 28 weeks primary hepatic pregnancy in a 25 year old female is reported. A live male fetus weighing 1300 g was delivered after laparotomy and the placenta was left intact. The uterus was of 8 weeks size with patent tubes. The patient made an uneventful recovery.     

卵巢妊娠1例

1临床资料 患者女，23岁，孕3产2，因停经40d，下腹痛3d，加重2h于2005年12月20日16时入院。末次月经2005年11月10日，12月1日阴道有少量出血，持续5d，自以为行经，未就诊。入院前3d无明显诱因出现右下腹隐痛，时轻时重，入院前2h腹痛加剧，呈撕裂样，以右侧为著，急就诊于我院。查体：面色轻度苍白，表情痛苦，腹部略膨隆，全腹压痛，以右侧为著，反跳痛，无肌紧张，移动浊音（＋）。妇科检查：宫颈举痛，摇摆痛（＋），子宫漂浮感，子宫前位，饱满，右侧附件区可触及包块约6em×5cm，压痛明显，左侧附件区触诊不满意。     

Laparoscopic management of an ovarian pregnancy

Ovarian pregnancy is a rare form of ectopic pregnancy. Here we report one such case that was successfully treated laparoscopically.