Background: Ovarian pregnancies comprise 0.15% of all pregnancies and 0.15-3% of ectopic gestations, with an incidence of up to 1/7,000 deliveries.
Case: A single case of an ovarian gestation consistent with Spieglberg's four criteria in a primigravida without prior gynecological, medical, or surgical history is presented. Presumptive diagnosis was by thorough clinical examination with a single, palpable, adnexal mass in a patient with BMI of 19, supported with serial ultrasound and quantitative betaHCG-enabled preoperative diagnosis.
Conclusion: Primary ovarian pregnancy may occur without any classical antecedent risk factors. Ultrasonography can be a useful adjunct to clinical presentation and physical examination in allowing the preoperative diagnosis of ovarian gestation.