Name of the Condition

• Unspecified ovarian pregnancy with intrauterine pregnancy

Summary

• This condition involves the simultaneous occurrence of a pregnancy located in the ovaries and a regular intrauterine pregnancy. It is a rare form of heterotopic pregnancy, where two gestational sacs are present, one in the uterus and the other ectopically outside the uterine cavity.

Causes

• Heterotopic pregnancies such as this may occur in natural conception or are more frequently associated with assisted reproductive technologies like in vitro fertilization.

Risk Factors

• Use of fertility treatments, particularly those involving ovulation induction.
• Previous history of ectopic pregnancies.
• Pelvic inflammatory disease.
• Previous pelvic surgery.

Symptoms

• Symptoms can be similar to those of an ectopic pregnancy, including pelvic pain, spotting, or bleeding.
• Abdominal pain or discomfort might also be experienced.

Diagnosis

• Ultrasound imaging is essential for identifying the locations of both gestational sacs.
• Blood tests, particularly checking human chorionic gonadotropin (hCG) levels, may provide additional insight.

Treatment Options

• Treatment typically involves surgical intervention to remove the ectopic ovarian pregnancy, often through laparoscopy, while carefully preserving the intrauterine pregnancy.
• In certain cases, medication may be used for ectopic pregnancy management, though the presence of an intrauterine pregnancy complicates this approach.

Prognosis and Follow-Up

• With timely intervention, the prognosis for the intrauterine pregnancy can be favorable.
• Regular monitoring of the intrauterine pregnancy is crucial to manage any potential complications early.

Complications

• If untreated, the ovarian pregnancy can lead to significant complications like ovarian rupture and intra-abdominal bleeding.
• Risks to the intrauterine pregnancy include miscarriage or preterm labor, depending on interventions and complications.

Lifestyle & Prevention

• While not entirely preventable, frequent monitoring and follow-ups during early pregnancies, especially when using fertility treatments, can aid in timely detection and management.

When to Seek Professional Help

• Immediate medical attention should be sought if experiencing severe abdominal pain, extensive vaginal bleeding, dizziness, or fainting during pregnancy.

Additional Resources

• American College of Obstetricians and Gynecologists (ACOG)
• Ectopic Pregnancy Trust
• Society for Maternal-Fetal Medicine

Tips for Medical Coders

• Ensure accurate documentation distinguishing between the locations of pregnancies (ovarian and intrauterine) for precise coding.
• Verify that code O00.219 is used only when both intrauterine and ovarian pregnancies are unspecified without further classification or detail available.
• Frequent errors include misclassification due to confusion with other forms of ectopic pregnancies; verify diagnosis based on physician documentation.