{"paper_id":"b6084ed1-2873-44c6-b4da-a717dc2bf130","body_text":"(ISSN: 2831-7416) Open Access \n \n \n          Journal of Case Reports and Medical History \nwww.acquirepublications.org/JCRMH \n                                                                 \n Ovarian Ectopic Pregnancy: A Case Study \n \nSaid Hasnae1,2, Hlaibi Omnia*,1,2, Gotni Aicha1,2, Lamrissi Amine1,2, Jalal Mohammed1,2, and Samouh Naima1,2  \n \n1Departement of gynecology and obstetrics, University Hospital Center Ibn Rochd, Casablanca 20100, Morocco \n2Faculty of Medicine and Pharmacy,Hassan II University of Casablanca,Casablanca, Morocco  \n*Corresponding author: Hlaibi Omnia, Departement of gynecology and obstetrics, University Hospital Center Ibn Rochd, Casablanca \n20100, Morocco and Faculty of Medicine and Pharmacy,Hassan II University of Casablanca,Casablanca, Morocco  \nReceived date: 25 Jan, 2026 |     Accepted date: 06 Feb, 2026 |     Published date: 11 Feb, 2026  \nCitation: Hasnae S, Omnia H, Aicha G, Amine L, Mohammed J, et al. (2026) Ovarian Ectopic Pregnancy: A Case Study. J Case Rep Med \nHist 6(1): doi https://doi.org/10.54289/JCRMH2600104 \nCopyright: © 2026 Aicha G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, \nwhich permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. \n \n \nIntroduction \nOvarian pregnancy (OP) is a type of pregnancy in which the \novary is the site of implantation [1]. It occupies a special place \namong ectopic pregnancies due to its rarity, which is linked \non the one hand to its definition, which takes anatomical \ncriteria into account, and on the other hand to well -codified \ndiagnostic procedures. Unlike other types of extrauterine \npregnancy (EUP), OP remains an isolated and exceptional \nphenomenon, independent of the usual risk factors. This is all \nthe more so given that the exact mechanism leadin g to OP is \nstill poorly understood. Compared to other EP, other forms of \nGO have been reported, such as GO that can progress into the \nsecond trimester or even to term [2]. The objectives of this \nstudy are to analyse the determining factors of GO and to \nsupport the aetiopathogenic, histopathological and \nevolutionary characteristics of this ectopic pregnancy. \nObservation \nMs. I R, aged 28, G2 P1, was admitted to the LALLA \nMERIEM Maternity Ward for light metrorrhagia, pelvic pain \nand a 4 -week delay in her period, with a history of using \ninjectable progestogen contraception for 8 years.  \nThe initial clinical examination found the patient conscious, \nwith a pulse rate of 118, blood pressure of 09/06, profuse \nsweating, and marked abdominal tenderness on the left side.  \nPelvic ultrasound showed an empty uterus (Figure 1) and a \n \nCase Report                                                                                                                                                                          Volume 6 – Issue 1 \nAbstract \nOvarian pregnancy is a rare type of ectopic pregnancy, accounting for about 3% of cases. It is characterized by implantation \nof the gestational sac within the ovary and differs from tubal ectopic pregnancy by the absence of typical risk factors. Its \npathophysiology remains unclear, although reflux of the fertilized ovum into the ovary is the most accepted theory.  \nWe report the case of a 28 -year-old woman presenting with pelvic pain, light metrorrhagia, and 4 weeks of amenorrhea. \nUltrasound showed an empty uterus and a left ovarian mass with a β -hCG level of 1650 IU/L. Surgical exploration \nconfirmed a left ovarian pregnancy with hemoperitoneum and normal fallopian tubes. Conservative surgical treatment was \nperformed. \nDiagnosis is challenging and often made intraoperatively or by expert ultrasound. Management is mainly surgical, and \nprognosis is generally favorable. \nAbbreviations: OP: Ovarian Pregnancy, EUP: Extrauterine Pregnancy, 3D: Three-Dimensional, MTX: Methotrexate \n \n \n \n\n                                                                                                                                                                                                   \n \nJournal of Case Reports and Medical History \nwww.acquirepublications.org/JCRMH                                                                                                                                        2 \n                                                                                                                                      2 \n \n6x6 cm mass on the left side of the uterus, affecting the left \novary (Figure 2), with BHCG at 1650 IU. \nSurgical exploration revealed a left-sided ectopic pregnancy, \nprofuse effusion, a slightly enlarged uterus, with no \nabnormalities in the left fallopian tubes or right adnexa \n(Figure 3). \nConservative treatment was performed (Figure 4). \n \nFigure 1: Radiological image of uterine emptiness \n \n \nFigure 2: Radiological image of the ovarian ectopic pregnancy mass \n \n \nFigure 3: Intraoperative ovarian ectopic pregnancy \n \n\n\n                                                                                                                                                                                                   \n \nJournal of Case Reports and Medical History \nwww.acquirepublications.org/JCRMH                                                                                                                                        3 \n                                                                                                                                      3 \n \n \nFigure 4: Conservative treatment \n \nDiscussion \nOvarian pregnancy (OP) accounts for 3% of ectopic \npregnancies [3]. Its pathophysiology is poorly understood, \nbut it appears to be secondary to reflux of the fertilised egg \nback into the ovary [3]. Cases of OP following in vitro \nfertilisation reported in the literature support the reflux theory \n[4]. The pregnancy implants preferentially on the scar of the \noriginal follicular ostium, which is rich in fibrin and new \ncapillaries [5]. This theory corresponds to the intra -follicular \nand juxtapositional forms. More rarely, this Implantation will \noccur away from the corpus luteu m or even on the \ncontralateral ovary, corresponding to the juxtacortical and \ninterstitial forms, the pathophysiology of which remains \nunclear. More rarely, ectopic pregnancy may be bilateral or \npart of a heterotopic pregnancy [6]. In our series, all \npregnancies were single and implanted on the side of the \ncorpus luteum. Unlike tubal ectopic pregnancies, tubal \npathology and surgery do not appear to increase the risk of \nGO. However, there is no consensus among authors on the \nrole of inflammatory pelvic pathologies in the genesis of GO \n[7]. Furthermore, contraception using an intrauterine device \nappears to be particularly associated with ovarian pregnancies \n[8]. Indeed, several authors studying series of 7 to 26 OPs [9] \nnoted that between 57% and 90% of patients had an \nintrauterine device. Clinically, painful abdominal and pelvic \nsymptoms precede the onset of the condition. These pains \ncorrespond to the rupture of the ovarian capsule due to \npregnancy and the formation of haemoperitoneum [10]. \nPatients are most often seen in an emergency setting, in a state \nof shock [11]. In our patients, abdominal and pelvic pain was \nindeed the primary symptom, and one patient was in \nhaemorrhagic shock. The diagnosis of ovarian pregnancy can \nbe made by ultrasound by a skilled operator. A gestational sac \nadjacent to the ovary can be seen, or, as some have described, \na double hyperechoic ring within a hypoechoic lateral uterine \nmass with or without an embryo [12]. In fact, depending on \nthe age of the pregnancy, several ultrasound im ages have \nbeen described in the literature [13]. Certain ultrasound \ncriteria are highly suggestive of an ovarian pregnancy: the \npresence of a round anechoic image with a hyperechoic \ncrown on the surface of the ovary, the presence of ovarian \nparenchyma such as a corpus luteum or follicle surrounding \nthe mass, and a higher echogenicity of the mass than that of \nthe ovary [14]. The differential diagnosis often involves a \ncorpus luteum cyst or a haemorrhagic cyst. In this case, three-\ndimensional (3D) ultrasound seems to be able to make the \ndistinction thanks to the cross -sectional planes [15]. Energy \nDoppler does not appear to be useful for diagnosis [16]. \nPulsed Doppler appears to be more useful. Several surgical \ntechniques have been described: wedge resection of the ovary \nremoving the GO, enucleation of the GO, cystectomy of the \ncorpus luteum removing the trophoblast, curettage of the \ntrophoblast with co agulation or haemostatic suturing of the \nGO bed with total preservation of the ovary [17]. In rare \ncases, due to the advanced stage of pregnancy, oophorectomy \nor even adnexectomy may be necessary [13]. This was the \ncase with our patient. Indeed, GO is often diagnosed at a stage \nwhere complications prevent the use of first -line medical \ntreatment [12]. The addition of methotrexate (MTX) may be \n\n\n                                                                                                                                                                                                   \n \nJournal of Case Reports and Medical History \nwww.acquirepublications.org/JCRMH                                                                                                                                        4 \n                                                                                                                                      4 \n \nconsidered as a follow -up to insufficient surgical treatment. \nWe did not use MTX. In terms of prognosis, GO does not \nconstitute a risk factor for a new ECT, due to the absence of \ntubal involvement. Only one case of GO recurrence has been \ndescribed in the l iterature, involving the contralateral ovary \n[11]. Pathological examination is of paramount importance, \nas it is the only way to confirm the diagnosis of GO. Its \npurpose is to eliminate primitive abdominal pregnancies, \nthose implanted on the ovary but orig inating from a tubo -\nabdominal abortion, and those where the ovary is not the \nexclusive site of implantation, according to Spielberg's \nanatomical criteria of 1878 [14] the fallopian tube on the \naffected side, including the fimbriated end, must be free of \nany lesions; the ovular sac must occupy the usual anatomical \nposition of the ovary; the ovary and gestational sac must be \nconnected to the uterus by the utero -ovarian ligament; there \nmust be ovarian tissue within the ovular sac, which implies \nhistological co nfirmation of the presence of chorionic villi \nwithin the ovarian tissue. Based on the anatomical criteria \ndefined by certain authors [15,16], several classifications of \nGO have been proposed. \nConclusion \nOvarian pregnancy is a rare condition that presents certain \nsemiological characteristics compared to other ectopic \npregnancies. It is difficult to diagnose. Treatment remains \nsurgical. Although rare, ovarian pregnancy remains an \nobstetric emergency with sp ecific semiology depending on \ncomplications at different stages of pregnancy. Its diagnosis \nremains difficult and is often made intraoperatively, through \nultrasound by an experienced practitioner, given the limited \npossibilities presented by the semiology, and is also based on \nintraoperative findings. Management is surgical despite \nadvances in medical treatment. Informed consent for the \npublication of their clinical details and/or clinical images has \nbeen obtained from the patient. \nConflict of interest \nThe authors declare no conflict of interest. \nReferences \n1. 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