ABSTRACT
Ovarian pregnancy is a rare form of the non-tubal ectopic pregnancy. It ends with rupture before the end of the first trimester. One of the important risk factors for ovarian pregnancy is in the use of Intra uterine devices [IUD]. We report here one such uncommon case of ovarian ectopic pregnancy. Our patient is a 30 years old multiparous woman with two previous cesarean sections with severe hypogastric abdominal pain. During laparotomy, ruptured ovarian ectopic pregnancy was diagnosed, and wedge resection of the ovary was only done. Histopathological examination confirmed it to be an ovarian ectopic pregnancy. IUD is one of contraceptive methods which prevents intra-uterine implantation in 99.5%, if implant occurs with IUD, it is tubal implantation in 95% of cases, and it is very rare in other places such as ovary. The most important risk factor of ovarian ectopic pregnancy is IUD as in this study it was showed
ABSTRACT
Our goal was to assess the diagnostic value of creatine phosphokinase [CPK] and its isoenzyme CPK- muscle brain [MB] in ectopic pregnancy [EP] in order to locate a simpler diagnostic approach for EP. This was a prospective study that performed consecutive sampling for 20 months in two major hospitals in Isfahan, Iran. All pregnant patients in their first trimester of gestation that presented with complaints of vaginal bleeding, abdominal pain, or both enrolled in this study. Blood sampling was performed for laboratory analyses [CPK, CPK-MB]. After their diagnosis was established, patients were put in either the EP or non-EP group. We used SPSS software version 10 for data analysis, diagnostic parameters were determined, and a relative operating characteristic [ROC] curve was plotted for each biochemical marker. A total of 106 patients, 53 in the EP group and 53 in the non-EP group enrolled in this study. The results for CPK were as follows: sensitivity [69.81%], specificity [64.15%], positive predictive value [PPV; 66.07%], negative predictive value [NPV; 68%], positive likelihood ratio [PLR] [1.95], and negative likelihood ratio [NLR] [0.49]. The results for CPK-MB were: sensitivity [71.7%], specificity [56.6%], PPV [62.29%], NPV [66.7%], PLR [1.65], and NLR [0.5]. The area under the ROC curve for CPK was 0.692 and for CPK-MB it was 0.647. Although we have observed a significant elevation in CPK and CPK-MB serum levels in EP, transvaginal ultrasound [TVS] is still the better diagnostic tool for EP.