Echogenic adnexal masses associated with first‐trimester pregnancy: Sonographic appearance and clinical significance

Pennes, David R.; Bowerman, Richard A.; Silver, Terry M.

doi:10.1002/jcu.1870130604

Cited by 7 publications

(3 citation statements)

References 16 publications

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“…Therefore, only 12 HOCs in adult patients have been reported, along with references in general artides on pelvic masses [3][4][5][6]. In these studies it was shown that HOCs have a variety of sonographic patterns.…”

mentioning

confidence: 99%

The spectrum of sonographic findings in hemorrhagic ovarian cysts

Baltarowich¹,

Kurtz²,

Pasto³

et al. 1987

American Journal of Roentgenology

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mentioning

confidence: 99%

The spectrum of sonographic findings in hemorrhagic ovarian cysts

Baltarowich¹,

Kurtz²,

Pasto³

et al. 1987

American Journal of Roentgenology

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“…It is believed that whilst adnexal masses occur in roughly 1:800 pregnancies, the prevalence of ovarian cancers in pregnancy has been reported as 1:653 [11,12]. Thus, although rare, ovarian tumors must be considered as a cause of the symptoms mimicking an ectopic pregnancy presentation.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of an Ectopic Pregnancy in the Pouch of Douglas and a Review of Abdominal Ectopic Pregnancies

Gabbott¹,

Verasingam²

2019

JCR

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Introduction: It is predicted that the prevalence of abdominal ectopic pregnancy ranges between 1:10,000 to 1:30,000 pregnancies. Maternally mortality is high, at an estimated 5-18%. In this report, we detail a case of an ectopic pregnancy implanted in the pouch of Douglas secondary to tubal abortion. Case Report: A 29 year old pregnant female presented to Accident & Emergency with a 12 hour history of severe, constant right iliac fossa pain and vaginal bleeding. Patient had severe tenderness in the right adnexa. Her beta human chorionic gonadotropin serum level was 31,382 IU/L. Ultrasound scan revealed a mass next to the uterus. A provisional diagnosis of an ectopic pregnancy was made. Ovarian malignancy and gestational trophoblastic disease were also considered. Diagnostic laparoscopy revealed large complex mass in the pouch of Douglas which was removed. She recovered well following the surgery. Conclusion: Ultrasound remains the gold standard for investigating an ectopic pregnancy or to rule out other differentials that can clinically present in the same manner. However, as only 50% accuracy can be assumed when diagnosing an early abdominal ectopic with ultrasound, a high index of suspicion is required. A diagnostic laparoscopy is invaluable in diagnosis and management of an ectopic pregnancy.

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“…However, in 1 study involving 31 patients with adnexal masses in pregnancy, 19 underwent surgical management, and 2 were found to have hemorrhagic cysts 14 . Another small study followed 9 patients with echogenic adnexal masses in early pregnancy, of which 2 of 9 were determined to be hemorrhagic corpus luteum cysts based on follow-up ultrasound in one case and pathology of the cyst after laparoscopic removal in the other case 35 . Hemorrhagic cysts often resolve by 14 to 16 weeks' gestational age 26 …”

Section: Types Of Adnexal Masses In Pregnancymentioning

confidence: 99%

Adnexal Masses in Pregnancy

Dotters‐Katz

Kuller

et al. 2021

Obstetrical &Amp; Gynecological Survey

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Importance: Adnexal masses are identified in approximately 0.05% to 2.4% of pregnancies, and more recent data note a higher incidence due to widespread use of antenatal ultrasound. Whereas most adnexal masses are benign, approximately 1% to 6% are malignant. Proper diagnosis and management of adnexal masses in pregnancy are an important skill for obstetricians.Objective: The aim of this study was to review imaging modalities for evaluating adnexal masses in pregnancy and imaging characteristics that differentiate benign and malignant masses, examine various types of adnexal masses, and understand complications of and explore management options for adnexal masses in pregnancy.Evidence Acquisition: This was a literature review using primarily PubMed and Google Scholar.Results: Ultrasound can distinguish between simple-appearing benign ovarian cysts and masses with more complex features that can be associated with malignancy. Radiologic information can help guide physicians toward recommending conservative management with observation or surgical removal during pregnancy to facilitate diagnosis and treatment. The risks of expectant management of an adnexal mass during pregnancy include rupture, torsion, need for emergent surgery, labor obstruction, and progression of malignancy. Historically, surgical removal was performed more routinely to avoid such complications in pregnancy; however, increasing knowledge has directed management toward conservative measures for benign masses. Surgical removal of adnexal masses is increasingly performed via minimally invasive techniques including laparoscopy and robotic surgery due to a decreased risk of surgical complications compared with laparotomy.Conclusions and Relevance: Adnexal masses are increasingly identified in pregnancy because of the use of antenatal ultrasound. Clear and specific guidelines exist to help differentiate between benign and malignant masses. This is important for management as benign masses can usually be conservatively managed, whereas malignant masses require excision for diagnosis and treatment. A multidisciplinary approach, including referral to gynecologic oncology, should be used for masses with complex features associated with malignancy. Proper diagnosis and management of adnexal masses in pregnancy are an important skill for obstetricians.Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After completing this activity, learners should be better able to compare different types of adnexal masses found in pregnancy, including incidence, clinical features, and imaging characteristics; evaluate an adnexal mass with imaging and laboratory tests; describe complications related to an adnexal mass in pregnancy; and determine management and/or surgical approaches for removal.

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Echogenic adnexal masses associated with first‐trimester pregnancy: Sonographic appearance and clinical significance

Cited by 7 publications

References 16 publications

The spectrum of sonographic findings in hemorrhagic ovarian cysts

The spectrum of sonographic findings in hemorrhagic ovarian cysts

A Rare Case of an Ectopic Pregnancy in the Pouch of Douglas and a Review of Abdominal Ectopic Pregnancies

Adnexal Masses in Pregnancy

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