{"paper_id":"17d536a8-14cb-4340-9e16-c71e17eebc9d","body_text":"Review began\n 08/22/2025 \nReview ended\n 09/04/2025 \nPublished\n 09/12/2025\n© Copyright \n2025\nMore et al. This is an open access article\ndistributed under the terms of the Creative\nCommons Attribution License CC-BY 4.0.,\nwhich permits unrestricted use, distribution,\nand reproduction in any medium, provided\nthe original author and source are credited.\nDOI:\n 10.7759/cureus.92159\nOvarian Ectopic Pregnancy: A Case Report of Two\nCases Highlighting Diagnostic and Management\nChallenges\nPradnya More \n, \nMegha \nMishra \n, \nSahar Mohamed \n1.\n Department of Obstetrics and Gynecology, Southend University Hospital, Southend-on-Sea, GBR\nCorresponding author: \nPradnya More, \npradnyakamble2791@gmail.com\nAbstract\nOvarian ectopic pregnancy (OEP) is a rare but potentially life-threatening form of ectopic gestation.\nAlthough recognized as a distinct clinical entity, its pathophysiology, diagnosis, and management remain\npoorly defined. Clinical presentation is often nonspecific and may mimic acute pelvic pathologies such as\nruptured corpus luteum, hemorrhagic ovarian cysts, or miscarriage in women presenting with vaginal\nbleeding. In some cases, it resembles a pregnancy of unknown location (PUL) when the gestation cannot be\nlocalized on imaging, complicating preoperative diagnosis. Prompt recognition is critical to avoid severe\nhemorrhagic complications, and laparoscopy remains the mainstay of both diagnosis and treatment.\nWe describe two cases with distinct clinical presentations: one involving a 34-year-old multiparous woman\npresenting with acute pelvic pain, vaginal bleeding, hemoperitoneum, and a hemorrhagic right ovarian\nlesion confirmed histologically as OEP, and another a 17-year-old nulliparous woman initially managed as a\nPUL who later presented with syncope, nausea, and vomiting, where laparoscopy revealed a bleeding\novarian mass, which is also confirmed histologically as OEP.\nOEP should be considered in reproductive-aged women presenting with acute abdominal pain,\nhemoperitoneum, and elevated beta human chorionic gonadotropin, even when ultrasound findings are\ninconclusive. These cases emphasize the need for a high index of suspicion and the role of laparoscopy in\ndiagnosis and management. Early surgical intervention reduces morbidity and preserves ovarian function.\nGiven its rarity and the absence of standardized guidelines, appropriate counseling is essential, and larger\ndatasets are needed to inform future diagnostic and management protocols.\nCategories:\n Obstetrics/Gynecology, Emergency Medicine, Pathology\nKeywords:\n corpus luteum hemorrhage, diagnostic challenges, ectopic pregnancy, hemoperitoneum, laparoscopy,\nmiscarriage, ovarian ectopic pregnancy, pregnancy of unknown location, transvaginal ultrasound\nIntroduction\nEctopic pregnancy accounts for approximately 1%-2% of all pregnancies and remains a leading cause of\nmaternal morbidity and mortality in the first trimester. Among its various forms, ovarian ectopic pregnancy\n(OEP) is one of the rarest subtypes, representing an estimated 0.5%-3.5% or approximately one in 7,000-\n40,000 live births of all ectopic gestations \n[1,2]\n. While traditionally considered uncommon, the reported\nincidence of OEP appears to be increasing, likely due to improved imaging techniques and heightened\nclinical awareness \n[3]\n.\nAlthough potentially life-threatening, the pathophysiology of OEP remains poorly understood. Diagnosis is\nparticularly challenging, as the clinical presentation often mimics other acute adnexal conditions such as\nruptured ovarian cysts, tubal ectopic, or hemorrhagic corpus luteal cysts. In many cases, clinical\nexamination, serum beta human chorionic gonadotropin (\nβ\n-hCG) levels, and imaging modalities like\nultrasound or MRI lack sufficient diagnostic sensitivity and specificity, which can result in both missed and\nmisdiagnosed cases, sometimes influenced by clinician bias \n[4,5]\n.\nWhile transvaginal ultrasound (TVS) with color Doppler can occasionally identify OEP preoperatively,\nlaparoscopy remains the gold standard for both diagnosis and treatment. Intraoperative findings may still be\ninconclusive, and definitive diagnosis is often established postoperatively using the modified Spiegelberg\ncriteria described by Wang et al., which include: 1) absence of pathological evidence of ipsilateral fallopian\ntube involvement and 2) demonstration of gestational tissue within the ovary, such as chorionic villi and/or\nan implantation site. If both criteria are satisfied, a diagnosis of primary ovarian pregnancy should be\nmade \n[6]\n. There is currently no consensus on optimal management, with variability in surgical approaches\nand limited discussion around ovarian-sparing techniques. Posttreatment follow-up protocols are also not\nwell established in current clinical guidelines.\nWe present two cases of OEP with markedly different clinical presentations. Both were managed with\n1\n1\n1\n \nOpen Access Case Report\nHow to cite this article\nMore P, Mishra M, Mohamed S (September 12, 2025) Ovarian Ectopic Pregnancy: A Case Report of Two Cases Highlighting Diagnostic and\nManagement Challenges. Cureus 17(9): e92159. \nDOI 10.7759/cureus.92159\n\ndiagnostic laparoscopy and confirmed on histopathological examination. These cases illustrate the\ndiagnostic challenges associated with OEP, emphasize the need for early surgical intervention, and highlight\nthe importance of developing more standardized diagnostic and management protocols.\nCase Presentation\nCase 1\nA 34-year-old woman with two previous vaginal deliveries presented with a seven-week history of\nintermittent vaginal bleeding that had worsened over the preceding 24 hours. She reported the passage of\nclots accompanied by left-sided pelvic pain radiating to the back, legs, and left shoulder tip. A urine\npregnancy test was positive. She was a known smoker and had no significant past medical or surgical\nhistory.\nOn examination, she was hemodynamically stable. Abdominal palpation revealed tenderness in the left iliac\nfossa. Speculum examination showed mild vaginal spotting, while bimanual examination revealed a uterus\nof approximately six to eight weeks' size with marked left adnexal tenderness.\nA TVS scan was arranged due to high clinical suspicion of an ectopic pregnancy. The scan revealed an\nanteverted uterus (95 × 43 × 57 mm) with a thin endometrial lining (2.5 mm) and no intrauterine gestational\nsac. The right ovary showed a collapsed corpus luteum and a second echogenic area with an anechoic center\nand peripheral vascularity, measuring 14 × 10 × 14 mm. These findings raised suspicion for either a\nsecondary corpus luteum or an ovarian ectopic pregnancy. A small trace of fluid was also seen exiting the\ncervix, consistent with ongoing bleeding (Figure \n1\n).\nFIGURE\n 1: Transvaginal ultrasound images of Case 1\n(a) Right ovary, where the double arrow indicates the cystic area suspicious for ectopic implantation vs. corpus\nluteum. (b) Right ovary with color Doppler showing vascular flow around the lesion, also referred to as the ring of\nfire sign. (c) Longitudinal view of the uterus with thin endometrium and no intrauterine gestational sac. (d) Right\novary, where the arrow points to a complex cystic mass with mixed echogenicity, consistent with either a\nhemorrhagic corpus luteum and/or ovarian ectopic tissue\nBlood investigations showed a serum \nβ\n-hCG level of 4,349 IU/L and a progesterone level of 7.6 nmol/L.\nDespite inconclusive imaging, the suspicion of ectopic pregnancy remained high. Considering a ruptured\ncorpus luteal cyst, ovarian ectopic pregnancy, and miscarriage as possible differentials, a diagnostic\nlaparoscopy was planned. The patient was counseled and consented to laparoscopy with the possibility of\nsalpingectomy, excision of ovarian ectopic tissue, or salpingo-oophorectomy if required.\nIntraoperatively, the uterus, left ovary, and left fallopian tube appeared normal. The right fallopian tube was\nalso unremarkable. However, the right ovary revealed a hemorrhagic area with ambiguous tissue.\nApproximately 200 mL of hemoperitoneum was evacuated, and the affected ovarian tissue was excised with\nhemostasis achieved by bipolar cauterization. The leading differential was a ruptured corpus luteum cyst,\nbut the possibility of an ovarian ectopic pregnancy could not be excluded (Figure \n2\n).\n \n2025 More et al. Cureus 17(9): e92159. DOI 10.7759/cureus.92159\n2\n of \n8\n\nFIGURE\n 2: Intraoperative images\n(a) Intra-abdominal view showing the pregnancy tissue obtained. (b) Right ovary with hemorrhagic lesion, ectopic\novary, and ruptured corpus luteum cyst. (c) Normal uterus, normal left fallopian tube, and normal left ovary. (d)\nRight ovary with hemorrhagic lesion\nRepeat serum \nβ\n-hCG the following day showed a decline to 1,837 IU/L. Histopathological analysis confirmed\nthe presence of chorionic villi within the excised ovarian tissue, establishing the diagnosis of a ruptured\novarian ectopic pregnancy. On long-term follow-up, \nβ\n-hCG returned to nonpregnant levels.\nCase 2\nA 17-year-old nulliparous woman with a positive urine pregnancy test was initially managed as a pregnancy\nof unknown location (PUL) following a one-day history of right iliac fossa pain. On clinical examination, she\nhad localized tenderness in the right iliac fossa. Initial serum \nβ\n-hCG was 265 IU/L, and serum progesterone\nwas 14.2 nmol/L. A TVS at the time revealed no evidence of an intrauterine or extrauterine pregnancy. She\nwas placed on expectant management with a plan for repeat \nβ\n-hCG at 48 hours and a follow-up scan one\nweek later.\nAt 48 hours, the \nβ\n-hCG had risen to 559 IU/L. However, on the day of her scheduled follow-up scan a week\nlater, the patient experienced a syncopal episode and vomiting at home and was brought to the emergency\ndepartment. On presentation, she was hemodynamically stable, with a blood pressure of 103/61 mmHg and\npulse of 84 bpm.\nA repeat TVS showed an anteverted uterus measuring 63 × 32 × 38 mm with an endometrial thickness of 5.1\nmm. Both ovaries were visualized and appeared morphologically normal, but were extremely tender on\nprobe pressure. Echogenic free fluid collections were identified in both adnexal regions, measuring 24 × 13\nmm on the right and 24 × 19 mm on the left, raising a strong suspicion of a ruptured ectopic pregnancy\n(Figure \n3\n).\n \n2025 More et al. Cureus 17(9): e92159. DOI 10.7759/cureus.92159\n3\n of \n8\n\nFIGURE\n 3: Transvaginal ultrasound images\n(a) Right adnexa with color Doppler showing a heterogeneous adnexal mass with internal vascularity. (b)\nEndometrium appears empty, without evidence of an intrauterine gestational sac. (c) Right ovary with the adnexal\nmass. (d) Right adnexa with color Doppler showing a well-defined, rounded mass with vascularity\nGiven the clinical picture, a diagnostic laparoscopy was performed. Intraoperative findings included 100-150\nmL of hemoperitoneum and a 1 × 1.5 cm actively bleeding mass on the right ovary. The uterus, both\nfallopian tubes, left ovary, appendix, and the remainder of the peritoneal cavity appeared normal. The right\novarian mass was excised using monopolar and bipolar diathermy, and hemostasis was achieved. The\nspecimen was sent for histopathological examination (Figure \n4\n).\n \n2025 More et al. Cureus 17(9): e92159. DOI 10.7759/cureus.92159\n4\n of \n8\n\nFIGURE\n 4: Intraoperative images of Case 2\n(a) Intraoperative image of the uterus with a normal left tube and ovary. (b) Right ovary with hemorrhagic\nchanges, posthemostasis with diathermy. (c) Another view of the right ovary showing an adnexal gestational sac-\nlike structure, possibly ectopic\nOn the day of surgery, serum \nβ\n-hCG had increased to 6,780 IU/L. Postoperatively, \nβ\n-hCG levels were\nrechecked at 48 hours and had dropped to 1,186 IU/L. Histopathological analysis confirmed the presence of\nchorionic villi in the excised tissue, consistent with a ruptured right ovarian ectopic pregnancy. Both\nfallopian tubes were confirmed to be uninvolved (Table \n1\n).\nCase\nInvestigation\nUnits\nFirst\npresentation\n48\nhours\nlater\nDay of\nsurgery\n24 hours\npostop\n48 hours\npostop\n2 weeks\npostop\nReference range\n1\nβ-hCG\nIU/L\n-\n-\n4,349\n1,837\n-\n37\n<5 (nonpregnant); doubles every 48 hours\nin viable intrauterine pregnancy\n1\nProgesterone\nnmol/L\n-\n-\n7.6\n-\n-\n2.3\n<20 nonviable pregnancy\n2\nβ-hCG\nIU/L\n265\n559\n6,780\n-\n1,186\n-\n<5 (nonpregnant); doubles every 48 hours\nin viable intrauterine pregnancy\n2\nProgesterone\nnmol/L\n14.2\n-\n10.3\n-\n2.6\n-\n<20 nonviable pregnancy\nTABLE\n 1: Serial \nβ\n-hCG and progesterone levels in Cases 1 and 2\nIn early viable intrauterine pregnancy, serum \nβ\n-hCG levels typically double approximately every 48 hours. A decline of >50% suggests a failing pregnancy,\nwhereas a suboptimal rise, plateau, or inadequate fall may indicate an ectopic pregnancy. Progesterone levels are variable depending on the stage and\noutcome of pregnancy; no definitive cutoff exists, but a value <20 nmol/L most likely indicates a nonviable pregnancy\nβ\n-hCG: beta human chorionic gonadotropin\nDiscussion\nOEP is an uncommon form of extrauterine gestation with significant diagnostic and therapeutic challenges.\nIts rarity, combined with nonspecific clinical and imaging findings, often leads to delayed or missed\ndiagnosis, increasing the risk of morbidity.\n \n2025 More et al. Cureus 17(9): e92159. DOI 10.7759/cureus.92159\n5\n of \n8\n\nOvarian pregnancy accounts for approximately 0.5%-3% of all ectopic pregnancies and occurs in an\nestimated one in 7,000-40,000 live births \n[7]\n. Over a five-year period, we identified two cases of OEP out of a\ntotal of 365 ectopic pregnancies managed at our center, corresponding to an incidence of 0.54%.\nPrimary ovarian pregnancy refers to the direct implantation of the gestational sac within the ovarian tissue.\nIn contrast, secondary ovarian pregnancy is thought to result from fertilization occurring in the fallopian\ntube, followed by retrograde migration of the conceptus into the ovarian stroma \n[8]\n. The first documented\ncase of ovarian pregnancy was described in 1682 \n[9]\n. The mean gestational age at diagnosis is approximately\nseven weeks. Due to the high risk of early rupture, the majority of OEPs, around 91%, are diagnosed and\nmanaged during the first trimester. A smaller proportion progress beyond this point, with 5.4% continuing\ninto the second trimester and only 3.7% reaching the third trimester \n[10,11]\n.\nThe overall incidence of ectopic gestation has increased, likely due to the rising prevalence of sexually\ntransmitted infections, pelvic inflammatory disease, the use of assisted reproductive technologies, and\nimproved access to diagnostic facilities. The incidence of OEP in particular has been linked to intrauterine\ncontraceptive device (IUCD) use. While IUCDs are effective in preventing intrauterine implantation, they do\nnot confer protection against extrauterine pregnancies. It has been postulated that IUCDs may promote\novarian implantation by altering prostaglandin synthesis, thereby increasing tubal motility and facilitating\nthe displacement of the fertilized ovum into ectopic locations, including the ovary \n[12]\n. This suggests that\nwomen using IUDs are more likely to develop an ovarian pregnancy than an intrauterine pregnancy, as the\nIUDs reduce the likelihood of intrauterine implantation but do not provide the same protective effect against\novarian implantation.\nRecent literature quotes an increased incidence of OEP with infertility and assisted reproductive techniques.\nThe incidence of ovarian pregnancy following in vitro fertilization embryo transfer (IVF-ET) is estimated at\naround 6% of all ectopic pregnancies, which is notably higher than the approximately 3% reported after\nnatural conception \n[13]\n. Several mechanisms have been proposed to explain this increased incidence. One\ntheory is reverse migration of a transferred embryo toward the fallopian tube, followed by implantation\nwithin the ovary. Lesny et al. demonstrated that a difficult embryo transfer can stimulate junctional zone\ncontractions and that strong endometrial waves originating in the fundal region may propel embryos into\nthe fallopian tubes \n[14]\n.\nThe etiology of OEP is not fully understood, although it is most commonly postulated to result from reflux\nof the fertilized oocyte into the ovary. Other proposed mechanisms include interference with the release of\nthe ovum from the ruptured follicle, dysfunction of the fallopian tubes, and inflammatory thickening of the\novarian tunica albuginea. Pathogenesis may involve fertilization occurring outside the fallopian tube,\nfollowed by implantation within the ovarian stroma. The ovary is covered by the tunica albuginea, a structure\ndevoid of muscle fibers, with loose connective tissue and blood vessels within. This lack of muscular support\nmay contribute to the tendency for early rupture. As the trophoblastic tissue invades the ovarian stroma, it\ndisrupts surrounding blood vessels, leading to rapid accumulation of intra-abdominal blood once rupture\noccurs. This explains why ovarian pregnancies frequently present with hemoperitoneum and, in some cases,\nhemodynamic instability. In addition, the absence of decidualized endometrium within the ovary may limit\nthe capacity of the tissue to accommodate implantation, further contributing to early rupture \n[15]\n.\nOEP presents with variable clinical features, often resembling those of a tubal ectopic pregnancy. Common\nsymptoms include a period of amenorrhea, irregular vaginal bleeding, and lower abdominal pain. On\nexamination, the uterus is usually of normal size, with adnexal tenderness, and, in some cases, a palpable\nadnexal mass. A proportion of patients may be asymptomatic. Abdominal examination may reveal\ntenderness, with or without guarding, indicating peritoneal irritation. In cases of rupture, patients may\ndevelop sudden, severe abdominal pain, and significant hemorrhage can lead to hypovolemic shock.\nIn 1878, Spiegelberg proposed the criteria for diagnosing ovarian pregnancy: 1) the ipsilateral tube must be\nintact, 2) the gestational sac must occupy a position in the ovary, 3) the ovary must be attached to the uterus\nthrough the utero-ovarian ligament, and 4) there must be ovarian tissue attached to the pregnancy in the\nspecimen. These criteria continue to be the standard for the diagnosis of ovarian pregnancy at the time of\nsurgery. They are useful to differentiate ovarian pregnancy from other types of ectopic pregnancy, but\ncannot be applied in ultrasound \n[16]\n.\nDespite improvements in modern ultrasound technology, identifying a ruptured OEP before surgery remains\nchallenging. In fact, a definitive preoperative diagnosis is made in only 5.3%-25% of cases \n[17]\n.\nUltrasonography may demonstrate a wide hyperechoic ring or mass caused by gestational trophoblastic\ntissue infiltrating the surrounding ovarian stroma, with echogenicity greater than that of a normal ovary or\ncorpus luteum. Additional sonographic findings can include a complex adnexal mass, with or without free\nfluid in the pouch of Douglas, and ovarian enlargement. Differentiating a ruptured ovarian pregnancy from a\nruptured tubal ectopic, hemorrhagic corpus luteum, or endometriotic (chocolate) cyst can be challenging\ndue to their similar ultrasonographic appearances. Terzić et al. reported that in 75% of cases, a ruptured\novarian pregnancy is sonographically mistaken for a ruptured corpus luteum \n[18]\n. We encountered a similar\ndiagnostic challenge in one of our cases, where the OEP was initially suspected to be a ruptured corpus\n \n2025 More et al. Cureus 17(9): e92159. DOI 10.7759/cureus.92159\n6\n of \n8\n\nluteum cyst.\nAccording to a retrospective case-control study conducted at a single center over a 10-year period, which\nexamined 20 women with OEP and compared them with 100 women with tubal ectopic pregnancy (TEP), key\nultrasound features of OEP include localization of the gestational sac within the ovarian stroma and the\ninability to separate the pregnancy from the ovary on gentle probe palpation. The use of color Doppler was\nfound to be valuable in demonstrating peritrophoblastic flow distinct from that of the corpus luteum;\nhowever, this finding is not entirely specific, as it may also be present in tubal pregnancies that are firmly\nadhered to the uterus or ovary \n[19]\n. The presence of a yolk sac or embryo within the ovarian cortex is highly\nspecific of an ovarian pregnancy.\nIn both of our patients, serum \nβ\n-high levels were elevated. Although TVS findings were inconclusive, there\nwas a suspicion of OEP based on imaging, coupled with symptoms of severe abdominal pain and\nsonographic evidence of hemoperitoneum. These factors prompted urgent laparoscopy, which proved\ncritical for timely diagnosis and intervention. However, diagnostic assessments such as an ultrasound may\nnot always be definitive. Lee et al. reported a patient with OEP who presented at 38 weeks' gestation with\ndecreased fetal movements; in this case, ultrasound failed to identify the OEP, instead showing a fetus in\nvertex presentation, and the gestational sac within the left ovary was only discovered intraoperatively \n[20]\n.\nWhile ultrasound plays a central role in the evaluation of ectopic pregnancies, a high index of suspicion\nremains essential, as it may fail to detect OEP in some cases. Routine prenatal assessments can facilitate\nearlier diagnosis and improve outcomes; nevertheless, some patients may remain undiagnosed despite\nappropriate antenatal care, adding to the complexity of diagnosis.\nIdeally, management should be initiated prior to rupture of the OEP. Treatment options are broadly similar\nto those for other ectopic pregnancies, with the choice of approach guided by the patient's clinical\npresentation, reproductive wishes, and the treatment protocols available at the treating facility.\nSurgical intervention serves both diagnostic and therapeutic purposes and is generally recommended as the\nfirst-line management option. The approach may involve laparoscopy or, in selected cases, laparotomy, with\nthe primary objectives being diagnosis and removal of the ectopic pregnancy tissue, achievement of\nhemostasis, and preservation of as much healthy ovarian tissue as possible. Laparotomy is indicated as an\nemergency in patients presenting with hemodynamic instability, such as hypovolemic shock, or in the\npresence of significant hemoperitoneum.\nMedical management of OEP remains a subject of debate, with limited evidence available in the literature.\nThe main advantage is the preservation of ovarian tissue, making it a potential option for young women\nwishing to maintain fertility. Methotrexate may be considered if specific criteria are met: 1) absence of\nhemodynamic instability, 2) no sonographic evidence of pelvic free fluid, 3) a gestational mass measuring\nless than 3.5 cm without fetal cardiac activity, and 4) a serum \nβ\n-high level below 3,500 IU/L \n[21]\n.\nConclusions\nOEP is a rare but potentially life-threatening condition, and clinical awareness is essential to reduce\nassociated morbidity and mortality. It should be considered in the differential diagnosis for women of\nreproductive age presenting with acute abdominal pain, even when hemodynamic parameters are stable.\nRisk factors such as current intrauterine device use and conception via IVF-ET may increase the likelihood of\nOEP, and affected patients often present with higher serum \nβ\n-hCG levels and more severe clinical outcomes,\nincluding rupture, hemoperitoneum, and shock.\nDiagnosis can be challenging due to nonspecific clinical features and overlapping imaging appearances with\nhemorrhagic ovarian cysts, bleeding corpus luteum, or tubal ectopic pregnancies. Sonographic\ninterpretation may be further limited by the presence of a hematocele or hemoperitoneum. Laparoscopy\nremains the gold standard for both diagnosis and management, with intraoperative confirmation guided by\nSpiegelberg's criteria. Early recognition is critical to preserve fertility, avoid the need for emergency\nlaparotomy, and improve clinical outcomes.\nAdditional Information\nAuthor Contributions\nAll authors have reviewed the final version to be published and agreed to be accountable for all aspects of the\nwork.\nConcept and design:\n  \nPradnya More, Megha \nMishra , Sahar Mohamed\nAcquisition, analysis, or interpretation of data:\n  \nPradnya More, Megha \nMishra , Sahar Mohamed\nDrafting of the manuscript:\n  \nPradnya More, Megha \nMishra\n \n2025 More et al. Cureus 17(9): e92159. DOI 10.7759/cureus.92159\n7\n of \n8\n\nCritical review of the manuscript for important intellectual content:\n  \nPradnya More, Sahar Mohamed\nSupervision:\n  \nSahar Mohamed\nDisclosures\nHuman subjects:\n Informed consent for treatment and open access publication was obtained or waived by all\nparticipants in this study. \nConflicts of interest:\n In compliance with the ICMJE uniform disclosure form, all\nauthors declare the following: \nPayment/services info:\n All authors have declared that no financial support\nwas received from any organization for the submitted work. \nFinancial relationships:\n All authors have\ndeclared that they have no financial relationships at present or within the previous three years with any\norganizations that might have an interest in the submitted work. \nOther relationships:\n All authors have\ndeclared that there are no other relationships or activities that could appear to have influenced the\nsubmitted work.\nReferences\n1\n. \nBouab M, Touimi AB, Jalal M, Lamrissi A, Fichtali K, Bouhya S: \nDiagnosis and management of ectopic\novarian pregnancy: a rare case report\n. 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DOI 10.7759/cureus.92159\n8\n of \n8","source_license":"CC0","license_restricted":false}