Antenatal laparoscopic management of ovarian cyst: a case report

Authors

  • Niyaf N. A. Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, Karnataka, India
  • Ravikanth G. O. Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, Karnataka, India
  • Geeta Doppa Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, Karnataka, India
  • Bhavya H. U. Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20211171

Keywords:

Laparoscopy, Ovarian cyst, Pregnancy

Abstract

The frequency of adnexal mass in pregnancy ranges from 2% to 10%, dermoid cyst is the most common ovarian germ cell tumor during pregnancy which could be asymptomatic or symptomatic, management through laparoscopy must be considered as it provides several advantages, including reduced postoperative pain, analgesic use, hospitalization time and better cosmetic result. Here we are reporting a case of an unbooked 35 years old primigravida at 16 weeks and 4 days gestation with history of retention of urine. Ultrasound showed a live foetus of 16 weeks gestation with bilateral mild maternal hydroureteronephrosis and complex cystic mass of 13×10 cm in right lumbar region suggestive of ovarian mass. Patient was clinically stable, hence exploratory laparoscopy was taken up the next day. Intraoperatively, dermoid cyst was found in the right ovary. Right ovarian cystectomy was performed. She had an uneventful postoperative period and discharged. She was monitored for the rest of the pregnancy and it was uneventful. She had spontaneous full term normal vaginal delivery of female baby weighing 2.8 kg. Although the patient was clinically stable, large ovarian cyst are predisposed for future complications, hence antenatal diagnosis and appropriate intervention is crucial for good outcome.

Author Biographies

Niyaf N. A., Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, Karnataka, India

Department of Obstetric and Gynecology

Ravikanth G. O., Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, Karnataka, India

Department of Obstetrics and Gynecology

Geeta Doppa, Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, Karnataka, India

Department Of Obstetrics and Gynecology

Bhavya H. U., Department of Obstetrics and Gynaecology, KVG Medical College and Hospital, Sullia, Karnataka, India

Department of Obstetric and Gynecology

References

Duic Z, Kukura V, Ciglar S, Podobnik M, Podgajski M. Adnexal masses in pregnancy: a review of eight cases undergoing surgical management. Eur J Gynaecol Oncol. 2002;23(2):133-4.

Hoover K, Jenkins TR. Evaluation and management of adnexal mass in pregnancy. Am J Obstet Gynecol. 2011;205(2):97-102.

Runowicz CD, Brewer M. Adnexal mass in pregnancy. Available at: https://www.uptodate .com/contents/adnexal-mass-in-pregnancy. Assessed on: 21 August 2020.

Jamor J, Conte AB, Alaoui FZF, Jayi S, Chaara H, Melhouf MA. Malignant transformation of ovarian mature teratoma: 04 cases report, review of the literature. Int J Reprod Contracept Obstet Gynecol. 2020;9:819-24.

Glanc P, Salem S, Farine D. Adnexal masses in the pregnant patient: a diagnostic and management challenge. Ultrasound Q. 2008;24(4):225-40.

Giuntoli RL, Vang RS, Bristow RE. Evaluation and management of adnexal masses during pregnancy. Clin Obstet Gynecol. 2006;49(3):492-505.

American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins – Gynecology. Practice Bulletin No. 174: Evaluation and Management of Adnexal Masses. Obstet Gynecol. 2016;128(5):210-26.

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(2):358-63.

Bunyavejchevin S, Phupong V. Laparoscopic surgery for presumed benign ovarian tumor during pregnancy. Cochrane Database of Systematic Reviews. 2013;1:CD005459.

Al-Fozan H, Tulandi T. Safety and risks of laparoscopy in pregnancy. Curr Opin Obstet Gynecol. 2002;14(4):375-9.

Yen CF, Lin SL, Murk W, Wang CJ, Lee CL, Soong YK, et al. Risk analysis of torsion and malignancy for adnexal mases during pregnancy. Fertil Steril. 2009;91(5):1895-902.

Whitecar MP, Turner S, Higby MK. Adnexal masses in pregnancy: a review of 130 cases undergoing surgical management. Am J Obstet Gynecol. 1999;181(1):19-24.

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(5):1098-103.

Caspi B, Appelman Z, Rabinerson D, Zalel Y, Tulandi T, Shoham Z. The growth pattern of ovarian dermoid cysts: a prospective study in premenopausal and postmenopausal women. Fertil Steril. 1997;68(3):501-5.

Sanaullah, F., Trehan, A.K. Ovarian cyst impacted in the pouch of Douglas at 20 weeks' gestation managed by laparoscopic ovarian cystectomy: a case report. J Med Case Rep. 2009;3:7257.

Neiswender LL, Toub DB. Laparoscopic excision of pelvic masses during pregnancy. J Am Assoc Gynecol Laparosc. 1997;4(2):269-72.

Soper NJ, Hunter JG, Petrie RH. Laparoscopic cholecystectomy during pregnancy. Surg Endosc. 1992;6:115-7.

Curet MJ, Vogt DA, Schob O, Qualls C, Izquierdo LA, Zucker KA. Effects of CO2 pneumoperitoneum in pregnant ewes. J Surg Res. 1996;63(1):339-44.

Sesti F, Pietropolli A, Sesti FF, Piccione E. Gasless laparoscopic surgery during pregnancy: evaluation of its role and usefulness. Eur J Obstet Gynecol Reprod Biol. 2013;170:8-12.

Balthazar U, Steiner AZ, Boggess JF, Gehrig PA. Management of a persistent adnexal mass in pregnancy: what is the ideal surgical approach? J Minim Invasive Gynecol. 2011;18(6):720-5.

Chen L, Ding J, Hua K. Comparative analysis of laparoscopy versus laparotomy in the management of ovarian cyst during pregnancy. J Obstet Gynaecol Res. 2014;40(3):763-9.

Downloads

Published

2021-03-24

Issue

Section

Case Reports