Missed ovarian pregnancy in early laparoscopic management

Objective: To report a case of repeat hemoperitoneum which was later proved to be a missed ovarian pregnancy in early laparoscopic management. Design: Case report. Setting: University hospital. Subject and intervention: A 31-year-old women who presented with haemoperitoneum was thought to have an ectopic pregnancy, but no substantial lesion was found at early laparoscopy. Haemoperitoneum recurred 10 days later, and repeat laparosopy revealed a ruptured ovarian pseudogestational sac at a site previously thought to be a corpus luteum. Main Outcome: Measure intraoperative transvagianl doppler ultrasonography confirmed the presence of pseudogestational sac. Postoperative histopathology proved the diagnosis of ovarian pregnancy. Result and Conclusion: The lesson learned from this case was the need to remove all suspicious ovarian masses, including the corpus luteum cysts, in early laparoscopic management in patients with otherwise 'negative' findings, in order to avoid missing an ovarian pregnancy.