This article discusses the possible etiology and the preoperative, operative, and postoperative management of five ovarian pregnancies based on the initial nonspecific signs and symptoms and the high risk of hemoperitoneum and/or hypovolemic shock of a ruptured ovarian pregnancy with the associated diagnostic problems. The advances made in transvaginal ultrasonography and monitoring of serum β-hCG levels in blood samples, as well as the substantial progress made in diagnostic pelviscopy and operative laparoscopy, have led to an early minimal invasive surgical management with the main emphasis on an organ-preserving procedure, i.e., a simple enucleation of the gestational sac with the utmost protection of the surrounding ovarian tissue.
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