A 30-year-old woman undergoes laparoscopy for a 3 cm right adnexal mass at 7 weeks gestation. The right fallopian tube appears stretched over the mass but is separate and intact. Histopathology of the excised specimen shows chorionic villi embedded within ovarian stroma adjacent to the corpus luteum. What is the diagnosis?
- A Ampullary tubal ectopic pregnancy
- B Abdominal pregnancy
- C Primary ovarian pregnancy ✓
- D Corpus luteum cyst with coexisting intrauterine pregnancy
Correct answer: C. Primary ovarian pregnancy
Explanation
Chorionic villi within ovarian tissue, with an intact ipsilateral tube lying separately, satisfy the classical Spiegelberg criteria for primary ovarian pregnancy. In an ampullary ectopic the conceptus lies within the tubal lumen, not within ovarian stroma. Abdominal pregnancy implants on peritoneal surfaces. A corpus luteum cyst contains no chorionic villi. Ovarian pregnancies rupture early because the ovarian stroma cannot distend, so preoperative suspicion is rarely high.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.