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  • Title: Ovarian pregnancy: association with IUD, pelvic pathology and recurrent abortion.
    Author: Reichman J, Goldman JA, Feldberg D.
    Journal: Eur J Obstet Gynecol Reprod Biol; 1981 Dec; 12(6):333-7. PubMed ID: 7333410.
    Abstract:
    Six cases of ovarian pregnancy were reviewed and their relationship with the IUD, fibromyoma of the uterus and previous spontaneous abortion was examined. In fact, 5 patients had an IUD in situ, in 2 women fibroids were found; 4 of the women had spontaneous abortions in their past history. The latter fact has been discussed, and it is suggested that this association may possibly contribute to an early diagnosis of ectopic pregnancy resulting in improved chances for conservative microsurgery. Attention is drawn to the fact that the diagnosis of ovarian pregnancy is often made only on microscopic examination. Thus, it is concluded that the true incidence of ovarian pregnancy may be higher than is apparent. 6 cases of ovarian pregnancy were reviewed and their relationship with the IUD, fibromyoma of the uterus, and previous spontaneous abortion was examined. 5 of the patients had in situ IUDs, and 1 patient was treated in conjunction with a 20 week size fibroid uterus. 1 of the patients with an IUD also had a fibroid uterus. 4 of the women had spontaneous abortions in their past history. All cases met Spiegelberg's requirements for the diagnosis of ovarian pregnancy. The 6 cases are summarized in table form. During the 4 year period that these 6 patients were treated, a total of 59 ectopic pregnancies were treated at the Hasharon Hospital in Petah-Tikva, Israel. 18 or 30.5% occurred in patients with in situ IUDs. Ovarian pregnancies constituted 10.2% of all the ectopic pregnancies and 20% of the ectopic pregnancies in the group of patients using IUDs. The possibility that the IUD may potentiate ovarian nidation must be considered. It has been suggested that the IUD causes changes in the synthesis of prostaglandins so that tubal peristalsis is increased, and this could increase the incidence of both tubal and ovarian pregnancies. 2 of the patients were initially treated for vaginal bleeding and pelvic pain by removal of their IUDs, and the proper treatment was delayed for 14 days. The ovarian pregnancy in the patient with the fibroid uterus was diagnosed only after histological examination of an incidental hemorrhagic mass found at laparotomy. The series of 6 cases of ovarian ectopic pregnancy seems to confirm the association, and it must also be noted that mild chronic salpingitis was reported on histopathological examination in only 1 case. No conclusion can be reached on the basis of such a small group of patients.
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