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Obstet Gynecol. 2005 May;105(5 Pt 1):1098-103.

Adnexal masses in pregnancy: surgery compared with observation.

Author information

  • 1Department of Obstetrics and Gynecology, Women & Infants' Hospital of Rhode Island, Brown University Medical School, Providence, Rhode Island, USA. KSchmele@mdanderson.org

Abstract

OBJECTIVE:

To estimate whether the delay of surgery impacts the risk of adverse maternal and fetal outcomes in patients diagnosed with an adnexal mass during pregnancy.

METHODS:

A review was performed of pregnant patients diagnosed with an adnexal mass 5 cm or greater in diameter. Data collected included age, gravity/parity, gestational age at diagnosis, and presenting symptoms. Ultrasound examinations were evaluated for mass size and complexity. Pregnancy outcome, complications, and surgical pathology were reviewed.

RESULTS:

Between 1990 and 2003, 127,177 deliveries were performed at our institution. An adnexal mass 5 cm in diameter or greater was diagnosed in 63 (0.05%) patients. Pathologic diagnosis was available for 59 (94%) patients. The remaining 4 patients were lost to follow-up and excluded from the analysis. Antepartum surgery was performed in 17 patients (29%): 13 because of ultrasound findings that suggested malignancy and 4 secondary to ovarian torsion. The remaining patients were observed, with surgery performed in the postpartum period or at time of cesarean delivery. The majority of masses were dermoid cysts (42%). Four patients were diagnosed with ovarian cancer (6.8% of masses, 0.0032% of deliveries), and one patient (1.7%) had a tumor of low malignant potential. Antepartum surgery due to ultrasound findings that caused concern was performed on all 5 women diagnosed with a malignancy or borderline tumor, compared with 12 (22%) of the patients with benign tumors (P < .01).

CONCLUSION:

In select cases, close observation is a reasonable alternative to antepartum surgery in patients with an adnexal mass during pregnancy.

PMID:
15863550
[PubMed - indexed for MEDLINE]
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