{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:53:35Z","timestamp":1777694015624,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med Insights Case Rep"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ovarian ectopic pregnancy is a rare form of non-tubal ectopic pregnancy. It can rupture before the end of the first trimester, causing hemoperitoneum, and present with signs and symptoms similar to other commoner abdominal emergencies or the pregnancy can continue intraperitoneally. Therefore, they are not often diagnosed preoperatively. Ultrasound can assist in diagnosis of ovarian ectopic pregnancy but the findings could be ambiguous or inconclusive. We present a case of ruptured ovarian ectopic pregnancy at the second trimester causing massive hemoperitoneum that was suspected as an intrabdominal malignancy co-existing with intrabdominal pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>She was a 34 year-old Nigerian unbooked G4P3+0, (3 alive), who presented to the labor ward on 21st January, 2021 with a complaint of a 6-week history of abdominal pain and swelling. Pain was insidious in onset, generalized, non-colicky, non-radiating, constant, no known aggravating or relieving factor, but it was of moderate intensity. She had amenorrhea with a positive serum pregnancy test without prior early ultrasound. At presentation, initial abdominopelvic ultrasound revealed intra-uterine viable pregnancy but repeat ultrasound done showed a left adnexal ectopic gestation and an echo-rich intraperitoneal fluid collection. Laparotomy was done and ovarian pregnancy was accurately diagnosed intra-operatively. Tissue samples from the ovary confirmed normal products of conception, namely chorionic villi, trophoblastic cells and ovarian stroma at histology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Despite advances in imaging techniques, the diagnosis of ovarian ectopic gestation is still very difficult. When premenopausal women present with amenorrhea, generalized non-colicky abdominal pain and swelling in combination with ambiguous findings of pregnancy on ultrasound in the absence of trauma, differential diagnoses should include ruptured ovarian pregnancy. Obstetricians should maintain a high index of suspicion to forestall delayed diagnosis and the potential maternal morbidity and mortality. However, the need for high-index of suspicion should be for any ectopic, not just ovarian pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795476231153285","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T04:46:35Z","timestamp":1676004395000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Challenges of Management of Ruptured Second Trimester Ovarian Pregnancy in Low-and Middle-Income Settings: A Case Report"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0390-2152","authenticated-orcid":false,"given":"George Uchenna","family":"Eleje","sequence":"first","affiliation":[{"name":"Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria"},{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald Okanandu","family":"Udigwe","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria"},{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5690-9892","authenticated-orcid":false,"given":"Tobechi Kingsley","family":"Njoku","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chukwuemeka Chukwubuikem","family":"Okoro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chukwudubem Chinagorom","family":"Onyejiaka","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric Chukwudi","family":"Ihekwoaba","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3606-233X","authenticated-orcid":false,"given":"Chinedu Onwuka","family":"Ndukwe","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology and Forensic Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onyedika Promise","family":"Anaedu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Emeka","family":"Chiemeka","sequence":"additional","affiliation":[{"name":"Department of Anatomic Pathology and Forensic Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4458-8216","authenticated-orcid":false,"given":"Chigozie Geoffrey","family":"Okafor","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Onyeka Chukwudalu","family":"Ekwebene","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Confidence Chinaza","family":"Offor","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Odili Aloysius","family":"Okoye","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Perpetua Chinedu","family":"Okolie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Divinefavour Echezona","family":"Malachy","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chimdindu Ifunanya","family":"Maduagwu","sequence":"additional","affiliation":[{"name":"Effective Care Research Unit, Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane-Rita Ifeoma","family":"Mmuotoo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekeuda Uchenna","family":"Nwankwo","sequence":"additional","affiliation":[{"name":"Rural Community Clinical School, School of Medicine, Deakin University, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chimezuru Ogechi","family":"Duru","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4698-6226","authenticated-orcid":false,"given":"Emeka Philip","family":"Igbodike","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nnaedozie Paul","family":"Obiegbu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joy Chisom","family":"Agbo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nwabueze Chidozie","family":"Okeke","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ogonna Onyeka","family":"Ezenwafor","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry Chinedu","family":"Nneji","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ogechi Odinakachukwu","family":"Dimgba","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Egwuatu","family":"Okonkwo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,2,10]]},"reference":[{"key":"bibr1-11795476231153285","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2021.106742"},{"key":"bibr2-11795476231153285","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i29.8894"},{"key":"bibr3-11795476231153285","volume":"9","author":"Begum J","year":"2015","journal-title":"J Clin Diagn Res"},{"key":"bibr4-11795476231153285","doi-asserted-by":"publisher","DOI":"10.47162\/RJME.61.4.01"},{"key":"bibr5-11795476231153285","first-page":"656","volume":"78","author":"Fernandez 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