Primary ovarian pregnancy

Primary ovarian pregnancy is a rare type of ectopic pregnancy, which is difficult to diagnose clinically and even intra operatively. Here we present a case of a 20-year-old woman with ruptured right ovarian pregnancy and dermoid cyst of left ovary.     

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 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 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 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.     

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.     

妊娠合并卵巢恶性肿瘤的处理

目的 探讨妊娠合并卵巢恶性肿瘤的治疗方案。方法 对1954年1月－2000年12月，本院收治的17例妊娠合并卵巢恶性肿瘤患者进行回顾性分析。结果 80年代前的11例均行全（或次全）子宫＋双附件切除术或肿瘤活检术。80年代后的6例均为I期病例，其中3例行一侧附件切除术，2例胎儿存活，6例母亲均健在。结论 对妊娠期卵巢恶性肿瘤者，处理原则是尽早手术，并根据具体情况加用化学药物等治疗。