| Ovarian pregnancy in association with an intrauterine device. | |
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MedLine Citation:
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PMID: 6133796 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Within a 1-year period, two cases of primary ovarian pregnancy associated with an intrauterine device (IUD) occurred in our institution. The clinical signs and symptoms were similar to those in any other ectopic pregnancy. Both cases satisfied the criteria of Spiegelberg. The final diagnosis was based on the histopathological findings. A review of the literature is presented summarizing the 53 cases reported until now. The association between IUD, ectopic pregnancy in general, and ovarian pregnancy in particular is discussed. 2 cases of primary ovarian pregnancy associated with an IUD occurred at the Rothschild University Hospital (Haifa, Israel) within a 1-year period. This report describes the 2 cases and summarized the 53 cases that were reported until now. In case 1, a 23-year old woman, gravida 1, para 1, abortus 0, presented with lower abdominal pain and faintness 1 hour after a curettage. Her past history revealed no pelvic inflammations or operations. Her period was reported to be regular every 28 days. She had been using a Cu-7 IUD for 24 months. A curettage to terminate the pregnancy had been performed outside the hospital, revealing no gross pregnancy tissue. At the same time the Cu-7 IUD had been removed. 1 hour later the patient had urgently been sent to the hospital because of fainting and severe abdominal pain. Pelvic examination revealed slight vaginal bleeding, external os open to the tip of a finger, a normal sized uterus, normal adnexa, and a tender bulging cul-de-sac. A culdocentesis was performed and revealed blood with clots. The suspected diagnosis was perforation of the uterus. On laparotomy the uterus was found to be of normal size with no signs of perforation. On the right ovary a bleeding mass of 2 x 2 cm was seen. A wedge resection of the right ovary was performed, with preservation of most of the ovarian tissue, and the patient received 1000 ml of whole blood. The postoperative course was uneventful. Histological examination revealed an ovarian pregnancy: within ovarian tissue a large corpus luteum was found with blood clots, and trophoblasts. A decidual reaction of the ovarian stromal tissue was diagnosed. The tissue from the curettage was diagnosed to be endometrium with decidual changes, without chorionic villi or trophoblasts. The 2nd patient, a 34-year old woman, gravida 4, para 3, abortus 1, presented with abdominal pain and vaginal bleeding for 7 days. She had carried a Lippes loop IUD for 18 months. The IUD had been removed on the 3rd day of the bleeding because of abdominal pain and her desire for another child. Culdocentesis revealed dark blood with clots. On laparotomy about 100 ml of blood were found in the peritoneal cavity. The uterus, both tubes, and the left ovary were normal. The right ovary was a 6 x 6 x 6 cm enlarged cystic hemorrhagic mass. A right oophorectomy was performed. The postoperative course was uneventful. Histologic examination revealed an ovarian pregnancy: within ovarian tissue blood clots, chorionic villi and corpus luteum were found. There are no specific clinical signs of ovarian pregnancy. Abdominal pain, irregular vaginal bleeding, and faintness are similar to those of other ectopic pregnancy. The type of IUD associated with ovarian pregnancy varies. The increasing association of ovarian pregnancies with copper IUDs seems simply to be related to the increasing prevalence of this type of IUD in recent years. |
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Authors:
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K de Vries; I Shapiro; S Degani; Z Levitan; A Mitrani; M Sharf |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Volume: 21 ISSN: 0020-7292 ISO Abbreviation: Int J Gynaecol Obstet Publication Date: 1983 Feb |
Date Detail:
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Created Date: 1983-07-29 Completed Date: 1983-07-29 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0210174 Medline TA: Int J Gynaecol Obstet Country: IRELAND |
Other Details:
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Languages: eng Pagination: 65-70 Citation Subset: IM; J |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Female Humans Intrauterine Devices / adverse effects* Intrauterine Devices, Copper / adverse effects Ovary Pregnancy Pregnancy, Ectopic / etiology*, pathology |
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