Adnexal Mass with Surgical Treatment in Pregnant Women at Maharat Nakhon Ratchasima Hospital
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Abstract
Background: The management of adnexal masses during pregnancy presents a difficult clinical decision. The abdominal surgery during pregnancy is risky to mother and fetus. On the contrary, conservative management may result in the spreading of cancer or serious complications such as the torsion or rupture of ovarian cysts.
Objective: To determine the incidence and the maternal fetal outcomes of pregnant women undergoing surgical management for adnexal mass.
Patients & Methods: A retrospective descriptive analysis of pregnant women who underwent surgical treatment of adnexal mass during pregnancy at the Department of Obstetrics and Gynecology, Maharat Nakhon Ratchasima Hospital between January 1st, 2005 and December 31st, 2009 was performed. Data collection included age, gravity, parity, gestational age (at the time of surgery and delivery), size of tumor, histopathological diagnosis and maternal outcomes.
Results: During the study period, there were 41,852 deliveries and 59 pregnant women with adnexal masses that required surgical management. The incidence of pregnant women with adnexal masses requiring surgical intervention during pregnancy was 1 in 709 deliveries. Of the 59 cases, only 51 records had complete data for analysis. And among these, 10 patients (19.6%) underwent emergency exploratory laparotomy whereas 41 patients (80.4%) underwent elective exploratory laparotomy before delivery. The most common pathological finding was mature cystic teratoma (49.0%). Only 2 cases showed malignant tumor or borderline malignant tumor (3.9%) : the first one was serous cystadeno- carcinoma stage la and the other was borderline mucinous cystadenocarcinoma. There was only 1 preterm delivery in the emergency surgery group. There was no significant difference between emergency and elective surgery groups in the terms of histopathological diagnosis, demographic characteristics and maternal outcomes.
Conclusions: The incidence of pregnant women with adnexal mass requiring surgical intervention during pregnancy at Maharat Nakhon Ratchasima hospital was 1 in 709 deliveries. Pregnant women who underwent emergency operation had the same adverse pregnancy outcomes compared with those who underwent elective operation.
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References
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