Ovarian pregnancy (OP) is a rare form of ectopic pregnancy and is still a medical challenge. Therefore, more studies about the time trends, risk factors and diagnostic measurements are needed for the efficient treatment of OP.
The datum of OP patients who were treated at the Second Hospital of Hebei Medical University from 2003 to 2018 was collected and a retrospective cohort study was preformed between OP and tubal pregnancy.
79 of all 6943 ectopic pregnancy (1.14%) were OP. The prevalence of OP following assisted reproductive technology showed an increasing trend over time, from 8.33% to 15.22%. Previous abdominal surgery was one of the risk factors of OP (OR 0.41, 95% CI 0.18–0.95, p = 0.04). Merely 2 (2.53%) patients were sonographically diagnosed as OP accorded with their discharge diagnosis. However, 56 (80.0%) accumulation of blood in the pelvis formed echo free areas could be clearly found by ultrasonography. A significant difference was found in serum β-hCG level among OP patients and tubal pregnancy patients (2762.73 ± 1915.24 mmol/L vs 1034.20 ± 915.32 mmol/L, p < 0.001).
The prevalence of OP following assisted reproductive technology is on the rise. History of abdominal surgery may be a high risk factor for OP patients who have the tendency of high β-hCG levels. The ultrasonic preoperative diagnosis is conductive to the early diagnosis of OP though the diagnosis accuracy is low.
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Aydin T, Yucel B, Aksoy H, Ekemen S (2016) Successful laparoscopic management of a rare complication after embryo transfer: ovarian pregnancy. A case report and up-to-date literature review. Wideochir Inne Tech Maloinwazyjne 10(4):574–579. https://doi.org/10.5114/wiitm.2015.55893
Shan N, Dong D, Deng W, Fu Y (2014) Unusual ectopic pregnancies: a retrospective analysis of 65 cases. J Obstet Gynaecol Res 40(1):147–154. https://doi.org/10.1111/jog.12146
Zhu Q, Li C, Zhao WH, Yuan JJ, Yan MX, Qin GJ, Zhang J (2014) Risk factors and clinical features of ovarian pregnancy: a case–control study. BMJ Open 4(12):e006447. https://doi.org/10.1136/bmjopen-2014-006447
Shaw JL, Dey SK, Critchley HO, Horne AW (2010) Current knowledge of the aetiology of human tubal ectopic pregnancy. Hum Reprod Update 16(4):432–444. https://doi.org/10.1093/humupd/dmp057
Farquhar CM (2005) Ectopic pregnancy. Lancet 366(9485):583–591. https://doi.org/10.1016/S0140-6736(05)67103-6
Spiegelber O (1878) Zur casuistic der ovarial Schwangerschft. Archiv für Gynaekologie 13:73–76. https://doi.org/10.1007/bf01991416
Melcer Y, Smorgick N, Vaknin Z, Mendlovic S, Raziel A, Maymon R (2015) Primary ovarian pregnancy: 43 years experience in a single institute and still a medical challenge. Isr Med Assoc J 17(11):687–690
Ghi T, Banfi A, Marconi R, Iaco PD, Pilu G, Aloysio DD, Pelusi G (2005) Three-dimensional sonographic diagnosis of ovarian pregnancy. Ultrasound Obstet Gynecol 26(1):102–104. https://doi.org/10.1002/uog.1933
Delplanque S, Le Lous M, Flévin M, Bauville E, Moquet PY, Dion L, Fauconnier A, Guérin S, Leveque J, Lavoué V, Nyangoh Timoh K (2020) Effectiveness of conservative medical treatment for non-tubal ectopic pregnancies: a multicenter study. J Gynecol Obstet Hum Reprod 20:101762. https://doi.org/10.1016/j.jogoh.2020.101762
Killick SR (2007) Ultrasound and the receptivity of the endometrium. Reprod Biomed Online 15(1):63–67. https://doi.org/10.1016/S1472-6483(10)60693-1
Paltieli Y, Eibschitz I, Ziskind G, Ohel G, Silbermann M, Weichselbaum A (2000) High progesterone levels and ciliary dysfunction—a possible cause of ectopic pregnancy. J Assist Reprod Genet 17(2):103–106. https://doi.org/10.1023/a:1009465900824
Seshadri S, Shirley P, Jaiganesh T, Uchil D, Jolaoso A (2010) In vitro fertilisation and embryo transfer for bilateral salpingectomies results in a ruptured ovarian ectopic pregnancy due to a tubal stump fistula: a case report and review of the literature. BMJ Case Rep. https://doi.org/10.1136/bcr.09.2009.2291
Ko PC, Liang CC, Lo TS, Huang HY (2011) Six cases of tubal stump pregnancy: complication of assisted reproductive technology? Fertil Steril 95(7):2432.e1–4. https://doi.org/10.1016/j.fertnstert.2011.03.069
Lesny P, Killick SR, Robinson J, Raven G, Maguiness SD (1999) Junctional zone contractions and embryo transfer: is it safe to use a tenaculum? Hum Reprod 14(9):2367–2370. https://doi.org/10.1093/humrep/14.9.2367
Strandell A, Waldenstrom U, Nilsson L, Hamberger L (1994) Hydrosalpinx reduces in-vitro fertilization/embryo transfer rates. Hum Reprod 9(5):861–863. https://doi.org/10.1093/oxfordjournals.humrep.a138606
Nackley AC, Mausher SJ (1998) The significance of hydrosalpinx in in vitro fertilization. Fertil Steril 69(3):373–384. https://doi.org/10.1016/S0015-0282(97)00484-6
Eschenbach DA (1992) Earth, motherhood, and the intrauterine device. Fertil Steril 57(6):1177–1179. https://doi.org/10.1016/S0015-0282(16)55069-9
Belfar H, Heller K, Edelstone DI, Hill LM, Martin JG (1991) Ovarian pregnancy resulting in a surviving neonate: ultrasound findings. J Ultrasound Med 10(8):465–467. https://doi.org/10.7863/jum.19220.127.116.115
Scutiero G, Di Gioia P, Spada A, Greco P (2012) Primary ovarian pregnancy and its management. JSLS 16(3):492–494. https://doi.org/10.4293/108680812X13462882736385
Goyal LD, Tondon R, Goel P, Sehgal A (2014) Ovarian ectopic pregnancy: a 10 years’experience and review of literature. Iran J Reprod Med 12(12):825–830
Goksedef BP, Kef S, Akca A, Bayik RN, Cetin A (2011) Risk factors for rupture in tubal ectopic pregnancy: definition of the clinical findings. Eur J Obstet Gynecol Reprod Biol 154(1):96–99. https://doi.org/10.1016/j.ejogrb.2010.08.016
Gracia CR, Barnhart KT (2001) Diagnosing ectopic pregnancy: decision analysis comparing six strategies. Obstet Gynecol 97(3):464–470. https://doi.org/10.1016/S0029-7844(00)01159-5
Odejinmi F, Rizzuto M, Macrae R, Olowu O, Hussain M (2009) J Minim Invasive Gynecol 16(3):354–359. https://doi.org/10.1016/j.jmig.2009.01.002
Hwang DW, Choi HW, Choi YY, Kim HS, Kim YA, Chun KC (2020) Obstet Gynecol Sci 63(2):209–212. https://doi.org/10.5468/ogs.2020.63.2.209
Di Luigi G, Patacchiola F, La Posta V, Bonitatibus A, Ruggeri G, Carta G (2012) Clin Exp Obstet Gynecol 39(3):390–393
Elwell KE, Sailors JL, Denson PK, Hoffman B, Wai CY (2015) Unruptured second-trimester ovarian pregnancy. J Obstet Gynaecol Res 41(9):1483–1486. https://doi.org/10.1111/jog.12726
The authors would like to thank Dr. Liu Bin for contributing to the draft manuscript.
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This respective study was approved by the Research and Ethical Committee of the Second Hospital of Hebei Medical University, China, basing on the 1964 Helsinki declaration and its later amendments.
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Zheng, J., Liu, M., Zhou, X. et al. An investigation of the time trends, risk factors, role of ultrasonic preoperative diagnosis of 79 ovarian pregnancy. Arch Gynecol Obstet (2020). https://doi.org/10.1007/s00404-020-05648-6
- Ovarian pregnancy
- Tubal pregnancy
- Ectopic pregnancy
- Assisted reproductive technology
- Risk factor