Background and Aim: The incidence of suspicious adnexal masses is on the rise during pregnancy due to advancement of ultrasonography in the modern era. The prevalence of adnexal masses varied from 6% to 25% in gestational age of <20 weeks during pregnancy. However, due to a paucity of large randomized studies, little is known regarding their treatment during pregnancy. The present study aimed to assess the surgical management of suspected adnexal masses during pregnancy. Material and Methods: This retrospective study was carried out on 28 suspected adnexal masses pregnant women in the Department of Gynecology, Saidu Group of Teaching Hospital Swat during the period from March 2022 to August 2022. Patients with definite indications were assessed through surgical intervention, tumor markers, MRI (Magnetic Resonance Imaging), and as per International Ovarian Tumour Analysis (IOTA) ultrasound rules. Pregnant women who had a laparoscopy or laparotomy before 20 weeks of pregnancy to treat an adnexal mass were enrolled. SPSS version 28 was used for data analysis. Results: The overall mean age was 28.4 ± 1.9 years with an age range from 18 years to 35 years. The mean gestational age was 16.4± 1.7 weeks. Of the total 28 suspected adnexal masses, the prevalence of benign and malignant cases were 22 (78.6%) and 6 (21.4%) respectively. Out of 28 cases, about 18 (64.3%) had laparoscopic surgery and 10 (35.7%) had laparotomy. The left upper quadrant entry technique was used in 17 (60.7%) cases. Due to extensive pelvic adhesion, 3 (10.7%) required conversion from laparoscopic to laparotomy surgery. The laparoscopic group lost considerably less blood (66.7 ±52.4 vs 148.9 ±178.0 mL, P.051) and had hospitalization for short duration (2.6 ±0.9 vs 3.7 ±1.2 days, P.005) than the laparotomy group. One woman miscarried shortly after undergoing surgery. Obstetric outcomes did not differ significantly between the laparoscopy and laparotomy groups. Conclusion: The present study concluded that surgical treatment of adnexal masses appears to benefit both the mother and the fetus during pregnancy. Thorough clinical examination, individualized imaging, and prompt action assist in the identification and management of suspected adnexal masses during pregnancy. Keywords: Surgical management, Adnexal masses, Pregnancy, Laparoscopy, Laparotomy

Background and Aim: Medically induced weight loss often restores ovulation among polycystic ovarian syndrome (PCOS) women with obesity. Women with PCOS are more likely to be obese and have abdominal fat than women without PCOS, which is the most prevalent metabolic condition in premenopausal women. The present study aimed to determine the fertility outcome in polycystic obese women after bariatric surgery. Patients and Methods: This cohort study was conducted on 56 polycystic women with obesity undergoing bariatric surgery in the bariatric surgery department of Luqman International Hospital, Saidu Sharif Swat for the duration from 2017 to 2022. Polycystic patients were investigated for main outcome such as liver birth rates and pregnancy. SPSS version 26 was used for data analysis. Results: The live birth rates and pregnancy rates in PCOS women seeking fertility were 83% and 94.8% whereas in control cases were 77.6% and 68.4% respectively. PCOS women took 34 ± 26 months to get pregnant for the first time following surgery, and controls took 31 ± 24 months. There was no significant difference between PCOS neonates and controls in terms of their birth weight means (2856 + 624 g vs. 3246 + 592 g), but the number of newborns with low birth weights was similar between the two groups. Maternal problems (18.4% in PCOS and 23.6% in controls) and newborn complications (24.6% in PCOS and 15.4% in controls) were uncommon, with no differences between groups. Conclusion: Women with PCOS were more likely to have high fertility rates after bariatric surgery, especially in those seeking fertility, with no difference between those with hyper androgenic PCOS and those without. There were few maternal or neonatal complications such as preeclampsia and gestational diabetes associated with these pregnancies. Keywords: Bariatric surgery, Polycystic patients, Obesity, Fertility outcome