Adnexal Masses in Pregnancy: Fetomaternal Blood Flow Indices During Laparoscopic Surgery

Candiani, Massimo; Maddalena, S; Barbieri, Maurizio; Izzo, Stefano; Alberico, Daniela; Ronzoni, Stefania

doi:10.1016/j.jmig.2012.03.008

Cited by 20 publications

(10 citation statements)

References 19 publications

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“…studied this condition in pregnant ewes and found that the sheep fetus has sufficient placental flow reserves or compensatory responses to maintain adequate gas exchange during a 1‐h, 20‐mmHg maternal CO 2 pneumoperitoneum. Recently, another study showed that laparoscopic techniques do not modify uteroplacental perfusion evaluated using non‐invasive ultrasonography in human pregnancy …”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy

Chen

Ding

Hua

2013

J of Obstet and Gynaecol

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Aim: The aim of the present study was to evaluate the surgical and obstetric results of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy. Material and Methods: Sixty-nine eligible patients who met our criteria were randomly divided into the laparoscopy group (n = 33) and the laparotomy group (n = 36). The two groups were compared for their surgical and obstetric outcomes and the extent of pelvic adhesion discovered in later cesarean section (CS). Results: The laparoscopy group had less blood loss (43 ± 15 vs 51 ± 13 mL, P = 0.02), shorter postoperative hospital stay (2.9 ± 0.5 vs 5.8 ± 0.6 days, P < 0.001), and lower postoperative pain score (2.7 ± 1.2 vs 5.9 ± 1.5, P < 0.001) compared with the laparotomy group. The operative time, neonates' Apgar scores and birthweights between the two groups showed no significant differences (P > 0.05). Sixteen patients in the laparoscopy group, and 15 patients in the laparotomy group underwent cesarean section. The filmy and dense type adhesion rate was significantly different between the laparoscopy group and the laparotomy group (6.25% vs 53.3%, and 0% vs 20%, respectively). Conclusions:The present results suggest that laparoscopy is a better choice than laparotomy for ovarian cyst during pregnancy, with less blood loss, less postoperative pain and less postoperative hospital stay. It offers a faster recovery, results in less pelvic adhesion and does not affect the fetus; however, studies encompassing larger numbers of cases are needed.

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Section: Discussionmentioning

confidence: 99%

Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy

Chen

Ding

Hua

2013

J of Obstet and Gynaecol

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“…However, studies have revealed that pneumoperitoneum does not modify human uteroplacental flow. 44 There is no difference in intrauterine fetal growth restriction or stillbirth rates between laparoscopy and laparotomy-managed cases. 45 There is no adverse fetal outcome when laparoscopy is performed with pneumoperitoneum of 12-15 mmHg intra-abdominal pressure.…”

Section: Surgical Approachmentioning

confidence: 93%

“…These relate to the risks of hypercarbia causing fetal acid‐base disturbance and the risk of reduced uterine blood flow, which may reduce placental flow following pneumoperitoneum. However, studies have revealed that pneumoperitoneum does not modify human uteroplacental flow . There is no difference in intrauterine fetal growth restriction or stillbirth rates between laparoscopy and laparotomy‐managed cases .…”

Section: Managementmentioning

confidence: 99%

“…There is no difference in intrauterine fetal growth restriction or stillbirth rates between laparoscopy and laparotomy‐managed cases . There is no adverse fetal outcome when laparoscopy is performed with pneumoperitoneum of 12–15 mmHg intra‐abdominal pressure . There is the potential risk of injury to the uterus during insertion of the primary port or the Veress needle.…”

Section: Managementmentioning

confidence: 99%

“…45 There is no adverse fetal outcome when laparoscopy is performed with pneumoperitoneum of 12-15 mmHg intra-abdominal pressure. 43,44 There is the potential risk of injury to the uterus during insertion of the primary port or the Veress needle. Alternative entry techniques such as the Hasson's and Palmer's entry point may be considered, especially when surgery is performed in the second trimester.…”

Section: Surgical Approachmentioning

confidence: 99%

See 2 more Smart Citations

Management of adnexal masses in pregnancy

Alalade

Maraj

2017

The Obstetric & Gynaecologis

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Key content Adnexal masses are commonly identified in pregnancy but they are rarely malignant. Most adnexal masses either resolve spontaneously or can be managed conservatively during pregnancy. Pregnancy may alter the serum levels of tumour markers, making the interpretation of results difficult. Surgery in pregnancy is indicated in cases of an acute abdomen and high suspicion of malignancy. In cases where there is a high suspicion of malignancy, a multidisciplinary approach is required taking into account the woman's age, gestation, parity, desire for fertility and the likely stage of disease. Learning objectives To be aware of the clinical presentation and ultrasound characteristics of clinically significant adnexal masses in pregnancy. To understand the limitations of investigations in pregnancy and the importance of a multidisciplinary approach in the management of complex adnexal masses. To be aware of the indications for surgery and evaluate the appropriateness, mode and timing of surgery in pregnancy.

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Ovary Cancer: Surgical Techniques and Innovative Treatments

Vargas-Hernández

Vargas-Aguilar

2015

International Manual of Oncology Practice

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Adnexal Masses in Pregnancy: Fetomaternal Blood Flow Indices During Laparoscopic Surgery

Cited by 20 publications

References 19 publications

Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy

Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy

Management of adnexal masses in pregnancy

Ovary Cancer: Surgical Techniques and Innovative Treatments

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