Published: 2021-02-24

Pregnancy with adnexal masses: an institutional experience and review of the literature

Anupama Bahadur, Modalavalasa Swetha Sri, Rajlaxmi Mundhra, Latika Chawla, Megha Ajmani, Tuba Afreen, Payal Kumari, Shloka Sharma


Adnexal masses in pregnancy are not uncommon. We prospectively analysed all cases with adnexal masses detected during pregnancy presented to our antenatal outpatient department from January 2019 to August 2020. Herein we report six such cases with their pregnancy outcome. Among the 6 cases, 3 were diagnosed during first trimester of pregnancy, 2 in third trimester and 1 was found incidentally during caesarean section. The mean age of the cases was 25.33+2.33 years. Two cases underwent oophorectomy and rest had ovarian cystectomy. In terms of histopathological findings, one was endometriotic cyst, two were borderline tumors (mucinous and serous variety) and three were mature cystic teratomas. There was no perinatal mortality, but 2 babies required NICU admission for observation. Mature cystic teratoma was the most common adnexal mass detected in our series. Timing of surgery depends on urgency of situation. Asymptomatic/small/unilocular cyst with low suspicion should be kept under observation and follow up throughout pregnancy.


Adnexal mass, Pregnancy, Mature cystic teratoma, Surgery

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Spencer CP, Robarts PJ. Management of adnexal masses in pregnancy. Obstetric Gynaecol. 2006;8(1): 14-9

Graham GM. Adnexal masses in pregnancy: diagnosis and management. Donald Sch J Ultrasound Obstetrics and Gynecol. 2007;1(4):66-74.

Cavaco-Gomes J, Jorge Moreira C, Rocha A, Mota R, Paiva V, Costa A. Investigation and Management of Adnexal Masses in Pregnancy. Scientifica (Cairo). 2016;2016:3012802.

Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Reproductive tract abnormalities. 23rd ed. New York: McGraw-Hill; 2010:912-25.

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

Gasim T, Al Dakhiel SA, Al Ghamdi AA. Ovarian tumors associated with pregnancy: a 20–year experience in a teaching hospital. Arch Gynecol Obstet. 2010;282(5):529-33.

Goh W., Bohrer J., Zalud I. Management of the adnexal mass in pregnancy. Curr Opin Obstet Gynecol. 2014;26:49-53.

Yacobozzi M, Nguyen D, Rakita D. Adnexal masses in pregnancy. Semin Ultrasound CT MR. 2012;33: 55-64.

Sayin NC, Inal HA, Varol FG. Pregnancies complicated by adnexal masses: a case series. Arch Gynecol Obstet. 2008;278(6):573-7.

Fatema N. Management and outcomes of ovarian masses measuring ≥5cm in pregnancy - a series of six cases. MOJ Clin Med Case Rep. 2016;5(3):451-9.

Ulker V, Gedikbasi A, Numanoglu C, Saygi S, Aslan H, Gulkilik A. Incidental adnexal masses at cesarean section and review of literature. J Obstet Gynaecol Res. 2010;36(3):502-5

Yen C-F, Lin S-L, Murk W. Risk analysis of torsion and malignancy for adnexal masses during pregnancy. Fertil Steril. 2009;91:1895-902

Koo Y-J, Kim T-J, Lee J-E. Risk of torsion and malignancy by adnexal mass size in pregnant women. Acta Obstet Gynecol Scand. 2011;90:358-61.

Lee GSR, Hur SY, Shin JC. Elective vs. conservative management of ovarian tumors in pregnancy. Int J Gynaecol Obstet. 2004;85:250-4.

Kumari I, Kaur S, Mohan H, Huria A. Adnexal masses in pregnancy: a 5-year review. Aust N Z J Obstet Gynaecol. 2006;46(1):52-4.

Pavlidis N. Coexistence of pregnancy and malignancy. Oncol. 2002;7:279-87

ACOG committee on obstetric practice. ACOG committee opinion no. 474: non obstetric surgery during pregnancy. Obstet Gynecol. 2011;1172:1420-1.