Ovarian tumours associated with pregnancy: a five year retrospective study in a tertiary care hospital

Authors

  • Sunanda N. Department of Obstetrics and Gynecology, Cheluvamba hospital, MMC & RI, Irwin road, Mysore - 570001, Karnataka, India
  • Akhila M. V. Department of Obstetrics and Gynecology, Cheluvamba hospital, MMC & RI, Irwin road, Mysore - 570001, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20151295

Keywords:

Histopathology, Ovarian tumors, Pregnancy, Surgery

Abstract

Background: Pregnancy with ovarian tumors was reviewed over a 5 year period to determine the types of ovarian tumors associated with pregnancy in patients undergoing surgery and also the maternal and fetal outcome.

Methods: This retrospective study of 17 cases of ovarian tumors treated surgically during pregnancy and puerperium was carried out at a tertiary hospital between June 2009 and June 2014 to determine the incidence, clinico pathological features and outcome.

Results: The overall incidence of ovarian tumor in pregnant woman undergoing surgery was 1 in 1693 (0.025%) deliveries. 52.87%   tumors were diagnosed in the first and second trimesters of pregnancy.  Ten (58.82%) presented as an emergency at different periods of gestation with torsion being the most common cause of surgery. Serous cyst adenoma (23.52%) and dermoid tumor (17.64%) were the most common types of ovarian tumors found in the study. The incidence of malignant tumors was one (5.88%).Maternal outcome was uneventful in all patients. Abortion rate was 100% in first trimester. Outcome in second trimester is inconclusive as few patients were lost to follow-up. Patients diagnosed in third trimester had an uneventful fetal outcome.

Conclusions: Ovarian tumors are encountered with greater frequency, most being benign and self-resolving with malignancy occurring in a small minority of cases. Removal of persisting or enlarging ovarian masses as soon as possible is important to obtain a final histologic diagnosis and rule out malignancy.

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References

Balci O, Gezginc K, Karatayli R, Acar A, Celik C, Colakoglu MC. Management and outcomes of adnexal masses during pregnancy: a 6-year experience. J Obstet Gynaecol Res. 2008;34:524–8.

Schmeler. Adnexal Masses in Pregnancy. VOL. 105, NO. 5, PART 1, 2005.

F.-H. Koo. An 11-year experience with ovarian surgery during pregnancy. Journal of the Chinese Medical Association. 2013;76:453.

Nelson MJ, Cavalieri R, Graham D, Sanders RC. Cysts in pregnancy discovered by sonography. J Clin Ultrasound. 1986;14:509 –12.

Creasman WT, Rutledge F, Smith JP. Carcinoma of the ovary associated with pregnancy. Obstet Gynecol. 1971;38:111– 6.

Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy: a review of 130 cases undergoing surgical management. Am J Obstet Gynecol. 1999;181:19 –24.

Sherard GB, Hodson CA, Williams HJ, Semer DA, Hadi HA, Tait DL. Adnexal masses and pregnancy: a 12-year experience. Am J Obstet Gynecol. 2003;189:358–63.

Bromley B, Benacerraf B. Adnexal masses during pregnancy: accuracy of sonographic diagnosis and outcome. J Ultrasound Med. 1997;16:447–54.

Novak ER, Lambrou CD, Woodruff JD. Ovarian tumors in pregnancy: an ovarian tumor registry review. Obstet Gynecol. 1975;46:401– 6.

Mazze RI, Kallen B. Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5,405 cases. Am J Obstet Gynecol 1989;161:1178–85.

Agarwal N, Parul Kriplani A, Bhatla N, Gupta A. Management and outcome of pregnancies complicated with adnexal masses. Arch Gynecol Obstet. 2003;267:148 –52.

Hill LM, Connors-Beatty DJ, Nowak A, Tush B. The role of ultrasonography in the detection and management of adnexal masses during the second and third trimesters of pregnancy. Am J Obstet Gynecol. 1998;179:703–7.

Thornton JG, Wells M. Ovarian cysts in pregnancy: does ultrasound make traditional management inappropriate? Obstet Gynecol 1987;69:717–21.

Bernhard LM, Klebba PK, Gray DL, Mutch DG. Predictors of persistence of adnexal masses in pregnancy. Obstet Gynecol 1999;93:585–9.

Osmers R. Sonographic evaluation of ovarian masses and its therapeutical implications. Ultrasound Obstet Gynecol. 1996;8:217–22.

Wang PH, Cheng MH, Lee WL. The choice of tocolytic drugs for preterm labor-comparison of COX-2 inhibitor and magnesium sulfate. J Obstet Gynaecol Res. 2008;34:439 e 40.

Morice P, Uzan C, Uzan S. Cancer in pregnancy: a challenging conflict of interest. Lancet. 2012;379:495 e 6.

Wang PH, Chang WH, Cheng MH, Horng HC. Management of adnexal masses during pregnancy. J Obstet Gynaecol. Res. 2009;35:597 e 8.

Schmeler KM, Mayo-Smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME. Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol. 2005;105:1098 e 103.

Katz L, Levy A, Wiznitzer A, Aheiner E. Pregnancy outcome of patients with dermoid and other benign ovarian cysts. Arch Gynecol Obstet. 2010;281:811 e 5.

Usui R, Minakami H, Kosuge S, Iwasaki R, Ohwada M, Sato I. A retrospective survey of clinical, pathologic and prognostic features of adnexal masses operated on during pregnancy. J Obstet Gynaecol. Res 2000;26:89 e 93.

Chang SD, Yen CF, Lo LM, Lee CL, Liang CC. Surgical intervention for maternal ovarian torsion in pregnancy. Taiwan J Obstet Gynecol. 2011;50:458 e 62.

Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, Soong YK. Risk analysis of torsion and malignancy for adnexal masses during. Pregnancy. Fertil Steril. 2009;91:1895 e 902.

Chen P, Yeh CC, Lee FK, Teng SE, Chang WH, Wang KC. Squamous cell carcinoma occurring in the pelvic after total hysterectomy and bilateral salpingo-oophorectomy for an ovarian mature teratoma with malignant transformation. Taiwan J Obstet Gynecol 2012;51:446 e 8.

Mazze R, Kallen B. Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5405 cases. Am J Obstet Gynecol 1989;161:1178 e 85.

Kuczkowski KM. A review of obstetric anesthesia in the new millennium: where we are and where is it heading? Curr Opin Obstet Gynecol. 2010;22:482 e 6.

Chohan L, Kilpatrick CC. Laparoscopy in pregnancy: a literature review. Clin Obstet Gynecol. 2009;52:557 e 69.

Reedy MB, Kallen B, Kuehl TJ. Laparoscopy during pregnancy: a study of five fetal outcome parameters with use of the Swedish health registry.Am J Obstet Gynecol. 1997;177:673 e 9.

Jackson H, Granger S, Price R, Rollins M, Earie D, Richardson W. Diagnosis and laparoscopic treatment of surgical diseases during pregnancy: an evidence-based review. Surg Endosc. 2008;22:1917 e 27.

Kizer NT, Powell MA. Surgery in the pregnant patient. Clin Obstet Gynecol 2011;54:633e41.

ACOG Practice Bulletin 106, July 2009. Intrapartum fetal monitoring:nomenclature, interpretation, and general management principles. Obstet Gynecol 2009;114:192 e 202.

ACOG Practice Bulletin 9, October 1999. Antepartum fetal surveillance.Int J Gynaecol Obstet 2000;68:175 e 85.

ACOG Committee on Obstetric Practice. ACOG Committee Opinion 474, February 2011: non-obstetric surgery during pregnancy. Obstet Gynecol. 2011;117:420 e 1.

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Published

2017-02-19

How to Cite

N., S., & V., A. M. (2017). Ovarian tumours associated with pregnancy: a five year retrospective study in a tertiary care hospital. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 4(6), 1965–1969. https://doi.org/10.18203/2320-1770.ijrcog20151295

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Original Research Articles