Surgical Management of Adnexal Masses in Pregnancy

Abstract

Surgical management of adnexal masses during pregnancy appears to have favorable outcomes for both mother and fetus.

Meta‐analysis comparing the safety of laparoscopic and open surgical approaches for suspected adnexal mass during the second trimester

“…The mean age of study participants ranged from 25.4 to 31.6 years. All study participants had undergone surgery during the second trimester of pregnancy except for one woman who underwent surgery at 11 weeks of pregnancy owing to suspicion of malignancy . There were six patients from three studies in whom laparoscopic surgery was unsuccessful, necessitating conversion to open surgery; these patients were considered to be part of the laparotomy‐treatment cohort.…”

“…There were six patients from three studies in whom laparoscopic surgery was unsuccessful, necessitating conversion to open surgery; these patients were considered to be part of the laparotomy‐treatment cohort. Of these individuals, one patient had a cystic teratoma that could not be elevated out of the pelvis without risk of rupture, and the other five patients had a mass that was too densely adhered to the pelvis to permit exposure in the operative field . Cystectomy was performed in 111 patients in the laparoscopy group and 106 patients in the laparotomy group; one woman in the laparoscopy group underwent adnexectomy and all other patients underwent oophorectomy .…”

“…Surgical outcomes (post‐operative adverse events, hospital stay, and operative duration) were available for all four studies. However, only three studies had sufficient estimated blood loss data for pooling. Two studies reported post‐operative pain scores, and one study evaluated pelvic adhesion among patients who underwent cesarean delivery.…”

Acute abdomen in early pregnancy caused by torsion of bilateral huge multiloculated ovarian cysts

“…10 They concluded that surgical management of adnexal masses during pregnancy appears to have favourable outcomes for the mother and the fetus. There was no significant difference in obstetric outcomes between the laparoscopy and laparotomy groups.…”

Large malignant ovarian tumors during pregnancy: two cases

“…A single cyst measuring less than 10 cm, one side, and without ascites can be left to 18 weeks without further medication; however, if the cyst persistently increases in size, surgical exploration is required. For mixed cysts larger than 5 cm, bilateral sides, or with nipple should be followed up with ultrasound; if it persists or the size increases by 30%–50%, surgical exploration is required 2,11,12. It has been reported that cysts larger than 15 cm are 12 times more likely to be malignant than cysts less than 6 cm in diameter 13.…”