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Peripartum ovarian masses.
1Department of Obstetrics and Gynaecology, Adelaide Women's and Children's Hospital, Australia.
Summary
Ovarian masses complicating pregnancy are common, with most being benign. Routine ovarian examination during cesarean delivery is recommended, as ultrasound often misses asymptomatic masses.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Medicine
- Surgical Pathology
Background:
- Ovarian tumors complicating pregnancy require careful management due to potential impacts on maternal and fetal outcomes.
- Advances in diagnostic imaging and pathology may alter the presentation and management strategies for these cases.
Purpose of the Study:
- To review the presentation, management, pathological findings, and pregnancy outcomes of ovarian masses complicating pregnancy.
- To evaluate the effectiveness of diagnostic methods and identify optimal management strategies.
Main Methods:
- Retrospective review of 84 cases of ovarian masses complicating pregnancy.
- Analysis of clinical presentation, diagnostic methods (ultrasound, aspiration cytology), pathological findings (histology), and pregnancy outcomes.
Main Results:
- Eighty-four cases of ovarian masses complicating pregnancy were identified.
- Most masses (47/84) were asymptomatic, with 29 incidentally discovered during cesarean section despite routine ultrasound.
- Benign cystic teratoma was the most common type; one borderline malignancy was found. Histology provided definitive diagnosis in all cases.
Conclusions:
- Routine examination of ovaries during cesarean section is crucial for detecting asymptomatic masses missed by antenatal ultrasound.
- While differentiating functional from neoplastic lesions can be challenging, most ovarian masses in pregnancy are benign, supporting conservative management where appropriate.