Gynecology World Conference 2026

Abstract

Ovarian pregnancy is a rare form of ectopic pregnancy. Its incidence is 0.5% to 1% of all ectopic pregnancies, or 1 in 7,000 to 40,000 births. Diagnosis is based on the four Spielberg criteria (Tehrani HG et al., 2024).

Ovarian ectopic pregnancy is associated with a high risk of maternal morbidity and mortality. If not diagnosed early and treated promptly, ectopic pregnancy can be life-threatening (Abdulkareem and Eidan, 2021).

We report a case of a ruptured ovarian ectopic pregnancy that was successfully resolved by laparotomy in the obstetric emergency department of the Central Army Hospital, Jakarta, Indonesia. This patient's diagnosis is reported based on the Spielberg criteria.

Laparotomy was performed due to hemodynamic instability due to intra-abdominal bleeding, with fetal heart rate still present. The patient's prognosis was low with prompt intervention. The risk of maternal death was reduced due to unilateral ovarian loss.

The findings during surgery met the Spielberg criteria (1878). The ipsilateral tube was intact and distinct from the ovary. The ectopic pregnancy occupied the ovary. The ectopic pregnancy was connected to the uterus by the utero-ovarian ligament. Ovarian tissue could be demonstrated histologically in the placenta.

Ophorectomy was performed in cases of uncontrolled bleeding or larger lesions. Systemic or local injection of methotrexate has been successfully used to treat small, unruptured ovarian pregnancies (Pagidas, 2013).