Which combination of operative findings establishes a primary ovarian ectopic pregnancy according to Spiegelberg criteria?
- A Gestational sac within the fallopian tube with ovarian tissue densely adherent to the tube
- B Gestational sac situated within the ovary, attached to the uterus by the proper ovarian ligament, ovarian tissue demonstrable in the sac wall, and the ipsilateral fallopian tube intact and separate ✓
- C Gestational sac implanted in the interstitial portion of the tube within the muscular wall of the uterus
- D Gestational sac free in the peritoneal cavity with the placenta implanted on the ovarian surface
Correct answer: B. Gestational sac situated within the ovary, attached to the uterus by the proper ovarian ligament, ovarian tissue demonstrable in the sac wall, and the ipsilateral fallopian tube intact and separate
Explanation
Spiegelberg criteria require four findings: the sac occupies the ovary itself, the ovary is connected to the uterus by the ovarian ligament, ovarian tissue is confirmed in the sac wall histologically, and the ipsilateral tube is intact and separate from the sac. These rules exclude tubal pregnancy, interstitial pregnancy, and secondary abdominal pregnancy with ovarian implantation, which correspond to options A, C and D respectively.
Reference: Berek and Novak's Gynecology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.