Management of incidental adnexal masses on caesarean section

Cengiz, Hüseyin; Kaya, Cihan; Ekin, Murat; Yeşil, Ali; Yaşar, Levent

doi:10.4103/0300-1652.104381

Cited by 5 publications

(3 citation statements)

References 12 publications

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“…Incidental findings of ovarian masses during cesarean section are infrequently occurring with an incidence of only 0.012%.The histopathology of most masses found during cesarean delivery are mature cystic teratoma (27%)and simple cysts (21.2%) [10].…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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

Fatema¹,

Badi²,

Moon³

2016

MOJCR

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“…38 Common adnexal lesions include simple cysts, hemorrhagic cysts, and hyperstimulated ovaries in patients who have undergone fertility assistance therapy. Lower abdominal pain is the most common symptom.…”

Section: Gynecologic Causes Adnexal Massesmentioning

confidence: 99%

Evaluating the Acute Abdomen in the Pregnant Patient

Masselli

Derme²,

Laghi

et al. 2015

Radiologic Clinics of North America

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“…Cengizet al 49 conducted a retrospective study by reviewing medical records of the patients who had incidental adnexal masses during cesarean section in Istanbul, Turkey. There were 38 cases of incidental adnexal masses which were discovered during the cesarean section.…”

Section: Ovarian Cystectomymentioning

confidence: 99%

Cesarean Section and Associated Surgeries: Feasibility and Surgical Outcomes

Dawood¹

2017

Women Health Open J

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Cesarean section being the most commonly performed surgery in Egypt, the incidents of cesarean delivery in general hospitals were found to be nearly 50.6%, whereas, in private hospitals such cases were reported to be much higher. Many disorders, either gynecological or non-gynecological could coexist or precede a cesarean delivery. These disorders need to be managed surgically; invariably most patients will prefer to undergo a cesarean section with concomitant surgery for any associated pathology. The feasibility and complications of such dual surgeries have been addressed in this review article.

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Management of incidental adnexal masses on caesarean section

Cited by 5 publications

References 12 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

Evaluating the Acute Abdomen in the Pregnant Patient

Cesarean Section and Associated Surgeries: Feasibility and Surgical Outcomes

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