Intraoperative findings suggest an ovarian pregnancy. Which set of criteria (Spiegelberg criteria) confirms true primary ovarian pregnancy?

• A Sac within the ovary, presence of a corpus luteum in the same ovary, and free blood in the peritoneal cavity
• B Sac within the ovary, tube stretched over the mass, absence of corpus luteum, and negative beta-hCG
• C Sac implanted on the ovarian surface, tube removed previously, and trophoblast invading the ovarian medulla
• D Sac within the ovary, connected to the uterus by the ovarian ligament, ovarian tissue in the sac wall on histology, and the ipsilateral tube intact and separate ✓

Explanation

Spiegelberg's four criteria define primary ovarian pregnancy: the gestational sac occupies the ovary, the ovary is attached to the uterus by the ovarian ligament, ovarian tissue is demonstrated histologically in the wall of the sac, and the ipsilateral fallopian tube is intact and clearly separate from the sac. These criteria exclude a secondary implantation from a tubal abortion, which is the main differential.

Reference: Shaw's Textbook of Gynaecology, 18th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.