A 26-year-old woman presents with acute right lower abdominal pain at 6 weeks gestation. Ultrasound shows an empty uterus, a normal-appearing right ovary with a 1 cm corpus luteum, and a gestational sac with a fetal pole and cardiac activity within the right ovary itself. Which criterion of Spiegelberg confirms the diagnosis of ovarian ectopic pregnancy?
- A The ipsilateral tube must be intact and separate from the gestational sac ✓
- B The gestational sac must show a fetal pole with cardiac activity
- C Serum β-hCG must exceed 2000 mIU/mL
- D The contralateral ovary must show a corpus luteum
Correct answer: A. The ipsilateral tube must be intact and separate from the gestational sac
Explanation
Spiegelberg's criteria for ovarian ectopic pregnancy require: (1) the tube on the affected side must be intact, (2) the gestational sac must occupy the position of the ovary, (3) the ovary must be connected to the uterus by the ovarian ligament, and (4) ovarian tissue must be present in the sac wall histologically. Option A reflects the first criterion. Cardiac activity, hCG level, and corpus luteum location are not part of Spiegelberg criteria.
Reference: Williams Obstetrics, 26th ed.
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Written and medically reviewed by the StethoPrep medical team.