International Journal of Research and Reports in Gynaecology

Aim: To present a rare case of ovarian ectopic pregnancy initially misdiagnosed as a tubal ectopic pregnancy and to highlight the importance of careful ultrasonographic assessment and intraoperative evaluation in establishing an accurate diagnosis.

Case Presentation: A 33-year-old G2P1001 at 8+6 weeks’ gestation presented with five days of vaginal spotting that progressed to heavier bleeding. Transvaginal Ultrasound suggested a right tubal ectopic pregnancy. At Laparotomy, however, a ruptured right ovarian ectopic pregnancy was identified, and right salpingo-oophorectomy was performed. The patient recovered uneventfully and was discharged on postoperative day two. Histopathology confirmed ovarian ectopic pregnancy. She opted for subdermal implant contraception.

Discussion: Ovarian ectopic pregnancy is rare, accounting for only 1-3% of ectopic pregnancies. Because it may mimic a tubal ectopic on ultrasonography, misdiagnosis is common. This case illustrates the limitations of imaging in early pregnancy, and it underscores the need for meticulous sonographic evaluation, consideration of ovarian ectopic pregnancy when findings are atypical and careful intraoperative inspection of pelvic structures. Early recognition is critical to reducing morbidity and preserving fertility when possible.

Conclusion: This case reinforces that ovarian ectopic pregnancy, though uncommon, should be considered in patients with suspected adnexal ectopic pregnancy. Accurate diagnosis relies on both high-quality imaging and thorough surgical assessment. Prompt surgical management can lead to good clinical outcomes, as demonstrated in this case.