Maternal adnexal masses in pregnancy

Area of Science:

• Obstetrics and Gynecology
• Diagnostic Imaging
• Oncology

Background:

• Maternal adnexal masses are increasingly detected during pregnancy due to widespread ultrasound use.
• Most detected masses are functional cysts that resolve spontaneously.
• Adnexal lesions can originate from various sources, including gynecologic, obstetric, and non-gynecologic origins.

Purpose of the Study:

• To review the diagnosis and management of maternal adnexal masses during pregnancy.
• To highlight the potential for certain lesions, like decidualized endometriomas, to mimic malignancy.
• To discuss current recommendations for risk assessment and future directions in artificial intelligence.

Main Methods:

• Review of current literature and clinical practice regarding maternal adnexal masses.
• Discussion of ultrasound findings and differential diagnoses.
• Analysis of management strategies, including conservative surveillance and surgical intervention.

Main Results:

• The majority of adnexal masses in pregnancy are benign and do not alter in ultrasound morphology.
• Decidualized endometriomas can present a diagnostic challenge, mimicking early-stage ovarian malignancies.
• Risk stratification for malignancy relies on subjective assessment and benign descriptors in the absence of validated mathematical models.

Conclusions:

• Accurate diagnosis and risk assessment of maternal adnexal masses are crucial for appropriate management during pregnancy.
• Conservative management with ultrasound surveillance is often feasible, but surgical intervention may be necessary based on malignancy risk.
• Artificial intelligence holds promise for improving the prediction of malignancy in the future.