This video shows Ovarian Pregnancy and free fluid in cul de sac.
Ovarian pregnancy refers to an ectopic pregnancy that is located in the ovary. Typically the egg cell is not released or picked up at ovulation but fertilized within the ovary where the pregnancy implants. Such a pregnancy usually does not proceed past the first four weeks of pregnancy.
The Pouch of Douglas (cul-de-sac or rectovaginal septum) is the space between the rectum and the uterus. This is the lowest part of the abdominal cavity.
The female pelvis is a complex and ever-changing area of the human body, and the pouch of Douglas is a particular area of contrast. Also known as the cul-de-sac, the pouch of Douglas exists between the uterus and the rectum and is the most dependent area of the pelvis, where fluids pool.
A small amount of fluid in the cul-de-sac is normal and is usually not of concern. If the fluid sample shows signs of pus or blood, the area may need to be drained. Sometimes blood can be a result of ruptured cyst or signs of an ectopic pregnancy.
Just 1-2% of all pregnancies are ectopic, and in 95% of those cases, the egg is fertilized in the fallopian tubes on its way to the uterus. In 0.5% of cases, including this one, the baby grows inside the ovary itself.
Pregnancy causes a lot of changes to the body. Some of those changes can cause mild discomfort or light cramping in the area around ovaries. Ovary pain may cause pain on one side of the lower abdominal or pelvic area. Any serious ovary pain should be reported to a doctor.
Typical symptoms of ovarian conception 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.
The conditions which are most commonly confused with an ectopic ovarian pregnancy, both clinically and pathologically, are a ruptured hemorrhagic corpus luteal cyst, “chocolate” cysts and a ruptured distal tubal ectopic pregnancy. Even then, it can be mistaken for a hemorrhagic corpus luteum or an ovarian cyst.
The egg attaches within the uterus and starts to grow. But in an ectopic pregnancy, the fertilized egg attaches (or implants) someplace other than the uterus, most often in the fallopian tube. In rare cases, the egg implants in an ovary, the cervix, or the belly. There is no way to save an ectopic pregnancy.
Because oophorectomy is a radical procedure for ovarian ectopic pregnancy, consideration should be given to the patient's age, fertility, her desire to have further pregnancies, and the size of the mass; wedge resection can also be another surgical option.
In a normal pregnancy, the β-HCG level doubles every 48-72 hours until it reaches 10,000-20,000mIU/mL. In ectopic pregnancies, β-HCG levels usually increase less. Mean serum β-HCG levels are lower in ectopic pregnancies than in healthy pregnancies. No single serum β-HCG level is diagnostic of an ectopic pregnancy.