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Ovarian pregnancy is known for its rarity, life threatening bleed and non-specific clinical and ultrasound features. It may present as an acute abdomen in a pregnancy of unknown location and can rapidly progress to shock. We report a rare case of natural conception presenting in premenstrual phase, with rupture despite low β-hCG levels, without a history of amenorrhoea and predisposing factors for ectopic pregnancy. This report emphasizes that a prompt intraoperative action on the basis of high suspicion index is lifesaving in such clinical situations where definitive diagnosis is confirmed later by histopathological report as per Von Spielberg's criterion.
Keywords: Ectopic pregnancy; Ruptured ovarian pregnancy; Ectopic rupture; Pregnancy of unknown location; Acute abdomen with early pregnancy