Ruptured Ovarian Ectopic Pregnancy Managed Laparoscopically With Subsequent Term Delivery After 2 years Follow-Up: A Case Report and Literature Review.

BACKGROUND: An ovarian ectopic pregnancy (OEP) is a very rare form of ectopic pregnancy. Ectopic pregnancies are 2% of pregnancies, and OEP are 0.5%-3% of all ectopic pregnancies, with an even rarer risk of recurrence. Diagnosis is aided via ultrasound and surgical assessment, but confirmation is via histopathology.

CASE: We present a case of a woman in her late 20 s (Gravida 2, Para 1-previous normal vaginal delivery at term) with a planned pregnancy who had presented after a private scan to find a right-sided OEP and free fluid in her abdomen. She had only complained of mild lower abdominal cramping and no pervaginal bleeding. After evaluation, including pelvic ultrasound in our Early Pregnancy Assessment Unit (EPAU) that suspected a right OEP, she had a laparoscopic resection of the right ovarian ectopic tissue, and histopathology confirmed OEP. She recovered well and went home the next day. Serum BHCG returned to normal after repeated testing for 4 weeks, her periods returned to normal after 3 months, and she had a pelvic ultrasound scan 8 months later which showed normal ovaries. Two years later, she conceived naturally and delivered vaginally at term as a low-risk uncomplicated pregnancy.

CONCLUSION: An OEP is very rare but can be effectively managed laparoscopically with very good outcomes and fertility preservation. Full-term delivery outcome observed in this case after 2-year follow-up.