A retrospective survey of clinical, pathologic, and prognostic features of adnexal masses operated on during pregnancy.
OBJECTIVE
To evaluate retrospective data concerning patients with adnexal masses that were managed surgically during pregnancy and their effect on fetal outcome.


METHODS
Data were reviewed concerning pregnant women who required surgery at our hospital between 1980 and 1997 for an adnexal mass.


RESULTS
In the past 19 years at our hospital a total of 69 Japanese women aged 28.5 +/- 3.4 years (including 2 women with twin pregnancies) were diagnosed with adnexal masses that required surgery. The masses (10.2 +/- 4.5 cm in the largest diameter) were removed at 13.9 +/- 3.7 weeks of gestation. The pathologic features of the 69 lesions were as follows: 33 mature cystic teratomas, 13 functional cysts, 8 mucinous cystadenomas, 6 endometriotic cysts, 4 paraovarian cysts, 3 serous cystadenomas, and 2 malignant neoplasms. Of the 60 patients for whom the outcome of pregnancy was available, 7 (12%) gave birth before 37 weeks of gestation, while 2 (3.3%) experienced spontaneous abortions. There were 3 perinatal deaths among the 60 infants. Two of these 3 infants died due to major anomalies.


CONCLUSIONS
Although larger studies are required for confirmation, our results suggest that an adnexal mass might be associated with an adverse fetal outcome. Surgical intervention at < 24 weeks of gestation per se might not have been related to the adverse outcomes. We emphasize that surgical intervention during pregnancy can be avoided in patients who have ultrasonographically pathognomonic features of benign cystic teratomas, which are the most common neoplasms operated on during pregnancy.
Usui
R
R
Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan.
Minakami
H
H
Kosuge
S
S
Iwasaki
R
R
Ohwada
M
M
Sato
I
I
D000290:Adnexa Uteri; D000328:Adult; D003536:Cystadenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D005833:Genital Neoplasms, Female / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D013513:Obstetric Surgical Procedures; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013724:Teratoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography