ReviewArchives of gynecology and obstetrics2026
Ovarian pregnancy: clinical characteristics, diagnostic challenges, and sonographic features-a multicenter case series with narrative literature overview.
Review in Archives of gynecology and obstetrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo describe the demographic, clinical, laboratory, imaging, and surgical features of 15 histologically confirmed ovarian pregnancies (OP) and to contextualize these findings within a narrative literature overview in order to improve clinical recognition and facilitate earlier diagnosis.
methodsA retrospective multicenter case series was conducted across two university-affiliated hospitals between 2012 and 2024. Women with histologically confirmed OP were included. Demographic data, risk factors, presenting symptoms, β-hCG dynamics, ultrasound findings, operative details, and postoperative outcomes were collected and analyzed.
resultsFifteen patients were identified. The mean age was 34.6 ± 4.2 years; 46.7% used an intrauterine device, 33.3% had prior cesarean delivery, and 13.3% conceived through assisted reproduction. Abdominal pain was the predominant symptom (86.7%), whereas vaginal bleeding occurred in 26.7%. The mean preoperative β-hCG level was 6,436 ± 5,570 mIU/mL and serial measurements showed inappropriate rises. OP was suspected preoperatively in 53.3% of cases; identification appeared higher in cases with formal ultrasound (85.7%), although this observation is limited by differences in imaging setting and documentation.. Observed sonographic features included a hyperechoic peripheral ring and a Doppler pattern demonstrating a single dominant feeding vessel; A trilaminar endometrial pattern was not observed in evaluable cases. Rupture occurred in 73.3% of patients with a median blood loss of 300 mL (IQR 10-2000 mL). All patients were treated surgically with ovarian preservation, and postoperative day-1 β-hCG declined by 59 ± 12%.
conclusionOP commonly presents with abdominal pain and minimal bleeding and carries a high rupture risk. The described sonographic patterns may represent hypothesis-generating observations that could support clinical suspicion and warranting further study.
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