Samira Yahya, Saeed R, Malik S, Saeed M.
Ruptured ovarian cyst or ovarian ectopic, presenting as a diagnostic dilemma.
Proceeding Shaikh Zayed Postgrad Med Inst Jan ;15(1):41-3.

Implantation of fertilized ovum at a site other than uterine cavity is terrified as ectopic pregnacy. ectopic pregnancy represents 1.6% of all reported pregnancies. One of the rare sites of implantation is ovary. Incidence of primary ovarian ectopic pregnancy is infrequent ranging , from 1:7000 to 1:40,000 pregnancies. The risk factors include high parity, intrauterine contraceptive device (IUCD) and pelvic inflammatory disease (PID). Although the classical or typical presentation includes amenorrhoea, vaginal bleeding or spotting, lower abdominal pain, deteriorating vital signs, absence of intrauterine gestation on USG and raised serum beta HCG levels; the presentation may be quite atypical and differential diagnosis from other conditions may be very difficult preoperatively. Here we discuss the case of a woman aged 32 years presenting on 19th day of liar eve de with lower abdominal pain and gradually worsening hemodynamics suggesting on USG bilateral ovarian cysts with free fluid around (Ruptured cyst?). The patient under went emergency laparotomy and cysts were removed. Histopathology later confirmed it to be ovarian ectopic pregnancy fulfilling Spiegelberg criteria.

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