RESUMO
BACKGROUND: Ovarian pregnancy (OP) is a low-frequency pathology but with devastating effects on women reproductive health. It is often difficult to distinguish from tubal or abdominal pregnancy. Diagnostic procedures and actual medical approaches to the treatment of OP are still a challenge. CLINICAL CASE: In this paper we present a 21 years old woman, seen at the Hospital as emergency abdominal pain and hypovolemic shock, with a pregnancy of 14 weeks of gestational age. Emergency laparotomy was performed and right salpingo-oophorectomy was made. The findings were massive hemoperitoneum with a live fetus implanted on the surface of the right ovary. H istopathology report fulfilled Spiegelberg's criteria of primary ovarian pregnancy. The association of IUDs and ectopic pregnancy are discussed as well as some basic aspects of trophoblast biology. CONCLUSION: Ectopic pregnancy is an obstetric problems including poorly understood pathophysiology, clinical diagnostic dilemma and a very poor arsenal of therapeutic options.