Ectopic pregnancy: a single-center experience over ten years.

PURPOSE: The aim of this study was to investigate characteristics associated with ectopic pregnancy (EP) that could be utilized for predicting morbidity or mortality. METHODS: This was a retrospective analysis of pregnancy-related records from a tertiary center over a period of ten years. Data on age, gravidity, parity, EP risk, amenorrhea duration, abdominal pain presence and location, ß-human chorionic gonadotropin (ß-HCG) level, ultrasound findings, therapeutic intervention, exact EP implantation site and length of hospital stay (LOS) were obtained from the database. The LOS was used as a proxy for morbidity and was tested for an association with all variables. All statistical analyses were conducted with Stata® (ver. 16.1, Texas, USA). RESULTS: The incidence of EP in a cohort of 30,247 pregnancies over a ten-year period was 1.05%. Patients presented with lower abdominal pain in 87.9% of cases, and the likelihood of experiencing pain was tenfold higher if fluid was detectable in the pouch of Douglas. Only 5.1% of patients had a detectable embryonic heartbeat, and 18.15% had one or more risk factors for EP. While most EPs were tubal, 2% were ovarian. The LOS was 1.9 days, and laparoscopic intervention was the main management procedure. The cohort included one genetically proven dizygotic heterotopic pregnancy (incidence, 3.3 × 10- 5) that was diagnosed in the 7th gestational week. The only association found was between the ß-HCG level and LOS, with a linear regression ß coefficient of 0.01 and a P-value of 0.04. CONCLUSION: EP is a relatively common condition affecting approximately 1% of all pregnancies. ß-HCG correlates with EP-related morbidity, but the overall morbidity rate of EP is low regardless of the implantation site. Laparoscopic surgery is an effective therapeutic procedure that is safe for managing EP, even in cases of heterotopic pregnancy.

Clinical analysis of 95 cases with ovarian pregnancy.

BACKGROUND: Ovarian pregnancy (OP) is a rare ectopic pregnancy, in which it is very difficult to achieve preoperative diagnosis. Ovarian blood supply in OP increases which will lead to intra-abdominal bleeding, hazarding women's lives. Surgical exploration should be conducted once cases of OP are suspected. OBJECTIVE: To investigate clinical characteristics, diagnosis, and therapy of OP. MATERIALS AND METHODS: A retrospective study was conducted in 95 patients with OP admitted to the present hospital from January 2005 to June 2014. RESULTS: OP accounted for 1.79% of ectopic pregnancy over the same period, of which 68.4% had a history of artificial abortion, 6.3% was treated with intrauterine contraceptive device (IUD), 87.4% had abdominal pain, 84.2% had a history of menopause, and 51.6% had vaginal bleeding. All patients had no preoperative diagnosis and underwent laparoscopic wedge resection of ovary or lesionectomy and were all were cured. CONCLUSION: Since the cause of OP is still unknown and it has no typical clinical manifestations, the present authors adopt blood P-hCG combined with B-ultrasound to improve the preoperative diagnosis. They prefer laparoscopic wedge resection of ovary or lesionectomy, which induce higher rate of intrauterine pregnancy and lower rates of ectopic pregnancy and infertility in re-pregnancy after surgery.

Embarazo ectópico ovárico: experiencia en 10 años del Hospital Universitario La Paz, Madrid, España / Ovarian ectopic pregnancy: 10-year experience at Hospital Universitario La Paz, Madrid, Spain

La gestación ectópica ovárica es muy infrecuente, presentando una incidencia de 1/2100-7000 gestaciones (0,5-3% de todos los ectópicos). Su diagnóstico es difícil y dada la poca experiencia, no está claro el tratamiento más adecuado. Se presentan seis casos clínicos, recogidos en nuestro hospital desde 2001 hasta 2011, destacando el difícil diagnóstico prequirúrgico así como el tratamiento realizado.

Ectopic ovarian pregnancy is very infrequent, with an incidence of 1/2100-7000 pregnancies (0.5-3% of all ectopic pregnancies). Diagnosis is difficult and due to few cases presented in the literature there is no consensus on the appropriate treatment. Here we review six clinical cases of ovarian ectopic pregnancy that presented to our hospital between 2001 and 2011, highlighting the difficult presurgical diagnosis and appropriate course of treatment.