Speaker
Description
Introduction: A pregnancy confined to ovary accounts for upto 3% of all ectopic pregnancy and is the most common type of nontubal ectopic pregnancy.
Objective: Ovarian ectopic can present as atypical presentation such as Adnexal mass.
Case Report: A 26yr old female G4P2L1A1 presented in Gynaecology OPD with Chronic dull aching abdominal pain on and off since 5 months.Occasionally pain would radiate to the right shoulder.There was no history of Amenorrhoea, No history of syncopal attack and her Menstrual cycle were Normal.
Patient gave history of Intake of unsupervised MTP pills 5 months back for 1.5 month of period of gestation. However she gave history of suction and evacuation done at some private setup for uncontrolled bleeding, however no records or ultrasound were available.After evacuation patient stopped bleeding and resumed her regular menses.On Admission at our hospital, patient was clinically and haemodynamically stable.
P/A-Vague discomfort over abdomen.
P/v-an irregular mass of approximately size 43cm felt in the Posterior fornix tender and fixed, No cervical motion tenderness.
Investigations:UPT-Positive,Hb-7.9g/dl,Beta HCG-271.60mIU/ml,CA-125-114.40U/ml.
Ultrasonography-Heterogenous solid cystic mass lesion seen closely adherent to right ovary of size 5.52.8cm showing mild vascularity.
Hospital Course: After taking written & informed consent with blood arrangement,patient taken for Exploratory laparotomy an intact pregnancy sac in the Right ovarian fossa,was in the process of expulsion. Uterus and both tubes were normal and away from the mass. Gestational Sac over the ovary removed gently. Corpus luteum was on right ovary itself with bleeding surface. Haemostatic sutures were applied to the site.Post operative single unit of blood was transfused.HPE –awaited.
Conclusions:High Index of suspicion of ectopic pregnancy should be made in every reproductive age women.Before prescribing any medical abortion confirmation of location to be done.
