PRIMARY OVARIAN ECTOPIC PREGNANCY DIAGNOSED PREOPERATIVELY AND TREATED BY CONSERVATIVE OVARIAN SURGERY: A CASE REPORT

Background: Ovarian ectopic pregnancy is a rare form of ectopic gestation, accounting for approximately 0.5 – 3% of all ectopic pregnancies. Its diagnosis remains challenging because clinical and ultrasonographic findings frequently mimic other ovarian pathologies, particularly hemorrhagic corpus luteum cysts. Early diagnosis and prompt management are essential to prevent severe hemorrhagic complications while preserving fertility. Case Presentation: We report the case of a 32-year-old nulliparous woman presenting with pelvic pain and 6 weeks of amenorrhea. Clinical examination revealed a hemodynamically stable patient with no signs of hypovolemic shock.Serum β-human chorionic gonadotropin (β-hCG) level was 5,400 mIU/mL. Transvaginal ultrasonography demonstrated an empty uterine cavity and a right ovarian gestational sac-like structure highly suggestive of ovarian ectopic pregnancy, associated with a moderate hemoperitoneum. Given the risk of ongoing intra-abdominal bleeding, surgical exploration by laparotomy was performed. Intraoperative findings confirmed a ruptured right ovarian ectopic pregnancy with moderate hemoperitoneum and intact ipsilateral fallopian tube. Conservative ovarian surgery consisting of ovarian wedge resection with preservation of the remaining ovarian tissue was successfully achieved. Histopathological examination confirmed the diagnosis by demonstrating chorionic villi embedded within ovarian tissue. The postoperative course was uneventful, and serial B-hCG measurements showed complete resolution.