Adnexal masses encountered during cesarean delivery

Başer, Eralp; Erkılınç, Selçuk; Esin, Sertaç; Toğrul, Cihan; Biberoğlu, Ebru; Karaca, Mujdegul Zayifoglu; Güngör, Tayfun; Danışman, Nuri

doi:10.1016/j.ijgo.2013.06.015

Cited by 29 publications

(28 citation statements)

References 20 publications

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“…But the effects of asymptomatic ovarian masses on the preterm labor rate is unknown, thus more studies are suggested. In recent studies there were no severe neonatal morbidity or mortality mentioned for those who had ovarian mass incidentally diagnosed during cesarean delivery [11].…”

Section: Discussionmentioning

confidence: 98%

Management and Outcomes of Ovarian Masses Measuring ≥5cm in Pregnancy - a Series of Six Cases

Fatema¹,

Badi²,

Moon³

2016

MOJCR

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Ovarian masses ≥5cm in diameter have been found in only 0.04-0.05% of pregnant women. Most of the adnexal masses encountered during pregnancy are simple cysts <5cm in diameter and about 70% would resolve by the early second trimester. The persistent cysts with gradual increase in size required surgical management. Adnexal masses requiring surgical intervention in pregnancy have been reported for around 1% to 2.3% of all gestations. In the series we reviewed 6 cases at different trimesters of pregnancy with ovarian masses measuring ≥5cm that were managed surgically in a regional hospital in Oman. We observed the maternal perinatal outcome after removal of cysts either by Laparotomy or during cesarean delivery. Ovarian masses with acute complications warranted immediate surgical intervention irrespective of gestational age and incidental findings of ovarian masses during cesarean section required removal to avoid delayed diagnosis of malignancy and repeat surgery. spontaneously with no history of ovarian stimulation treatments. On general examination she was vitally stable. However abdominal examination revealed that a palpable mass at the middle of the lower abdomen corresponding to 20 weeks in size was tender on palpation. Baselines of all investigations were within normal limit. Eventually a radiology ultrasound revealed that the gravid uterus with intra uterine alive fetus corresponding to 8 weeks of gestation and a huge anechoic well defined cystic lesion in the middle of lower abdomen measuring 13.8x8.8cm with no doppler signal around it. Both ovaries were masked by the mass. Minimal amount of free fluid was seen in the pouch of Douglas. An urgent laparotomy was undertaken, during which a large unilocular thick walled right-sided ovarian cyst was detected measuring around 14x8.5cm in size (Figure 1). The cyst was twisted twice with clear fluid inside it. A right ovarian cystectomy was then carried out, and around 1700 ml clear fluid aspirated from the cyst. The remaining ovarian tissue and fallopian tube were preserved. Postoperatively she was placed on oral progesterone (Tab Dydrogesterone 10 mg BID) support upon hospital discharge. Histopathology report confirmed serous cyst adenoma in the ovary with signs of torsion. Tumor markers were within the normal limit. She was on regular ANC follow up which was uneventful. At 40 weeks and 1 day of gestation she delivered by a spontaneous vaginal delivery of a live baby of weighting 3 kg with Apgar score 9/1 minute and 10/5 minute. Keywords Case 2A 31 year old female G2P1 at 24 weeks of gestation arrived at our ANC clinic with complaints of a sudden onset of lower abdominal pain since the past 4 hours .She was registered at 9 weeks of gestation at the local health center and was put on regular ANC follow up afterwards. Upon physical examination, her vital signs were within normal limits but she appeared to be in distress due to continuous pain. Upon abdominal examination the lower right quadrant was revealed to be tender on palpation, with voluntary guardin...

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Section: Discussionmentioning

confidence: 98%

Management and Outcomes of Ovarian Masses Measuring ≥5cm in Pregnancy - a Series of Six Cases

Fatema¹,

Badi²,

Moon³

2016

MOJCR

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“…A review of the literature supports MCT as the common histological diagnosis in ovarian cysts removed during pregnancy, as they are functional cysts . These were associated with favorable maternal and fetal outcomes, but as malignancy was discovered in a minority of these patients, their removal as part of cesarean delivery seems advisable . In our study, all non‐cesarean surgeries in pregnant patients were performed via laparoscopy, with gestational age ranging from 5 to 28 weeks.…”

Section: Discussionmentioning

confidence: 75%

“…16,17 These were associated with favorable maternal and fetal outcomes, but as malignancy was discovered in a minority of these patients, their removal as part of cesarean delivery seems advisable. 18,19 In our study, all non-cesarean surgeries in pregnant patients were performed via laparoscopy, with gestational age ranging from 5 to 28 weeks. Indeed, this has previously been demonstrated to confer a safe and practical surgical approach during pregnancy, and our favorable study results support this management.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of mature cystic teratomas: A comparison of emergent and elective surgeries

Herman

Sagiv

Raphaeli

et al. 2016

J of Obstet and Gynaecol

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“…Hastaların %24'ünde dermoid kist, %19'unda paratubal/paraovaryan kist, %15'inde basit seröz kist, %18'inde müsinöz/seröz kistadenom, %5'inde endometriyoma, %5'inde korpus luteum saptanmıştır. 3 Çalışmadan da görüleceği gibi, gebelikteki adneksiyal kitlelerin nadir bir bölü-münü maligniteler oluşturmaktadır. Bunların 1/3'ü epitelyal over tümörü, 1/3'ü germ hücreli tümör-ler, 1/3'ü ise seks-kord stromal tümörleri ve metastatik tümörleri içermektedir.…”

Section: Discussionunclassified

Preterm Labor in 29 Weeks Pregnancy with Krukenberg Tumor

Seyhan¹,

Ulukent²,

Erdem³

et al. 2017

Turkiye Klinikleri J Case Rep

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Adnexal masses encountered during cesarean delivery

Abstract: Adnexal masses encountered during cesarean delivery generally have a favorable prognosis in terms of maternal and fetal outcome.

Cited by 29 publications

References 20 publications

Management and Outcomes of Ovarian Masses Measuring ≥5cm in Pregnancy - a Series of Six Cases

Management and Outcomes of Ovarian Masses Measuring ≥5cm in Pregnancy - a Series of Six Cases

Surgical treatment of mature cystic teratomas: A comparison of emergent and elective surgeries

Preterm Labor in 29 Weeks Pregnancy with Krukenberg Tumor

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