Laparoscopic management of ovarian ectopic pregnancy misdiagnosed at elective surgical termination of pregnancy: A report of two cases and review of the literature

Abstract

Although ectopic pregnancy diagnosed after elective termination of pregnancy is a very rare event, the incidence is increasing. The risk of mortality among women with ectopic pregnancy undergoing termination of pregnancy is 1.3 times higher than for women with ectopic pregnancy not undergoing a termination of pregnancy. Ovarian pregnancy is one of the rarest forms of ovarian pregnancy, sometimes difficult to diagnose as it can be confused with a tubal ectopic pregnancy or a haemorrhagic ovarian cyst. Early diagnosis of this rare entity is now possible owing to the developments in transvaginal ultrasound and availability of highly specific radioimmunoassay for the human chorionic gonadotrophin. Once the diagnosis has been made and surgical treatment planned, operative laparoscopy is a simple, safe and effective method of treating the majority of cases of ovarian ectopic pregnancy. We report two cases of ovarian ectopic pregnancy diagnosed following surgical termination of first trimester pregnancies and safely managed with operative laparoscopy. Our aim is to highlight the importance of proper ultrasonographic evaluation before termination of pregnancy and that ovarian ectopic pregnancy should be considered in the differential diagnosis of women presenting with abdominal pain after therapeutic termination of pregnancy. © Springer-Verlag 2010.