Terzić M, Stimec B, Maricić S
Department of Ob/Gyn, School of Medicine, University of Belgrade, Yugoslavia.
Zentralbl Gynakol. 2001 Mar;123(3):162-4. doi: 10.1055/s-2001-12528.
The diagnosis of ovarian pregnancy is based on the improper rise of serum beta-hCG levels, sonographic findings of an empty uterus, highly characteristic ovarian formation with double hyperechogenic ring surrounding small hypoechogenic field, and the laparoscopic verification of Spiegelberg's criteria. We present a case of ovarian pregnancy in spontaneous cycle in 34-year-old woman following two unsuccessful IVF/ET procedures and ovarian pregnancy on contralateral side laparoscopically treated seven months ago, also achieved in non-stimulated, spontaneous cycle. On admission she had a serum hCG level of 596 mIU/mL on cycle day 46 and an empty uterus. Transvaginal sonography showed a 20 mm ring-like thick-walled hyperechogenic structure within the left ovary. The echogenic ring was surrounded by irregular, hypoechogenic structures suggestive of an ovarian pregnancy with periluteal hemorrhage and blood clots. The ruptured cystic ovarian pregnancy and the corpus luteum were removed by laparoscopy. During the procedure we have seen two clips on the right ovary placed laparoscopically to achieve hemostasis after rupture of the ovarian pregnancy seven months ago. Histopathology showed isolated chorionic villi within hemorrhagic areas in the vicinity of the corpus luteum.
卵巢妊娠的诊断基于血清β - hCG水平上升异常、超声检查发现子宫内空虚、具有高度特征性的卵巢结构（小的低回声区周围有双高回声环）以及腹腔镜检查符合斯皮格尔伯格标准。我们报告一例34岁女性自然周期中的卵巢妊娠病例，该女性此前两次体外受精/胚胎移植（IVF/ET）手术均未成功，且七个月前对侧卵巢妊娠经腹腔镜治疗，此次也是在未刺激的自然周期中发生。入院时，在月经周期第46天她的血清hCG水平为596 mIU/mL，子宫内空虚。经阴道超声检查显示左侧卵巢内有一个20毫米的环状厚壁高回声结构。该高回声环被不规则的低回声结构包围，提示为伴有黄体周围出血和血凝块的卵巢妊娠。通过腹腔镜切除了破裂的囊性卵巢妊娠物和黄体。在手术过程中，我们看到右侧卵巢上有两个七个月前腹腔镜放置的夹子，是为卵巢妊娠破裂后止血所用。组织病理学显示在黄体附近的出血区域内有孤立的绒毛膜绒毛。
