The diagnosis is made in asymptomatic pregnant women by obstetric ultrasonography. On pelvic examination a unilateral adnexal mass may be found. Typical symptoms are abdominal pain and, to a lesser degree, vaginal bleeding during pregnancy. Patients may present with hypovolemia or be in circulatory shock because of internal bleeding. Ideally, ultrasound will show the location of the gestational sac in the ovary, while the uterine cavity is "empty", and if there is internal bleeding, it can be identified. Because of the proximity of the tube, the sonographic distinction between a tubal and an<unk>  may be difficult. Serial hCG levels generally show not the normal progressive rise. In a series of 12 patients the mean gestation age was 45 days. Histologically, the diagnosis has been made by Spiegelberg criteria on the surgical specimen of the removed ovary and tube. However, the tube and ovary are not usually removed as sonography allows for earlier diagnosis and surgeons strive to preserve the ovary. Prior to the introduction of Spiegelberg's criteria in 1878, the existence of<unk>  was in doubt; his criteria helped to identify the<unk>  from other ectopics: * The gestational sac is located in the region of the ovary. * The gestational sac is attached to the uterus by the ovarian ligament. * Ovarian tissue is histologically proven in the wall of the gestational sac. * The oviduct on the affected side is intact (this criterion, however, holds not true for a longer ongoing<unk> . An<unk>  can be mistaken for a tubal pregnancy or a hemorrhagic ovarian cyst or corpus luteum prior to surgery. Sometimes, only the presence of trophoblastic tissue during the histologic examination of material of a bleeding ovarian cyst shows that an<unk>  was the cause of the bleeding.
Ovarian pregnancy
Ovarian cyst
Ectopic pregnancy
Tubo-ovarian abscess
Cervical pregnancy
Ovarian disease
Abdominal pregnancy
Interstitial pregnancy