title: Adnexal masses in pregnancy: fetomaternal blood flow indices during laparoscopic surgery.
abstract: OBJECTIVE
  To assess changes in uterine and umbilical arteries during laparoscopy in human pregnancy.
  
  
  METHODS
  Case series (Canadian Task Force classification III).
  
  
  METHODS
  University tertiary care referral center for high-risk pregnancy and minimally invasive surgery.
  
  
  METHODS
  Nine pregnant women who underwent first- and second-trimester laparoscopic surgery because of an adnexal mass.
  
  
  METHODS
  Laparoscopic cyst enucleation or annessiectomy.
  
  
  RESULTS
  No maternal complications and no miscarriages or adverse pregnancy outcome occurred. Mean (SD) gestational age at delivery was 39.1 (0.7) weeks, birth weight was 3390 (298) g, and Apgar score at 5 minutes was 9.6 (0.5). Mean uterine resistance index, umbilical artery pulsatility index, and fetal heart rate were measured using transvaginal ultrasonography at various times during surgery. Mean uterine resistance index and umbilical artery pulsatility index values remained constant during laparoscopy. Fetal heart rate was maintained in the normal range (120-160 bpm) but progressively decreased during the surgical procedure.
  
  
  CONCLUSIONS
  In human pregnancy, laparoscopic techniques do not seem to modify uteroplacental perfusion evaluated using noninvasive ultrasonography.
authors.affiliation: Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, Milan, Italy. massimo.candiani@hsr.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Candiani
authors.forename: Silvia
authors.initials: S
authors.lastname: Maddalena
authors.forename: Maurizio
authors.initials: M
authors.lastname: Barbieri
authors.forename: Stefano
authors.initials: S
authors.lastname: Izzo
authors.forename: Daniela
authors.initials: D
authors.lastname: Alberico
authors.forename: Stefania
authors.initials: S
authors.lastname: Ronzoni
mesh_terms: D000328:Adult; D001034:Apgar Score; D001724:Birth Weight; D001783:Blood Flow Velocity; D005260:Female; D005350:Fibroma / Q000601:surgery; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D010535:Laparoscopy; D050498:Live Birth; D010048:Ovarian Cysts / Q000601:surgery; D010051:Ovarian Neoplasms / Q000601:surgery*; D021041:Placental Circulation; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*; D013724:Teratoma / Q000601:surgery*; D018608:Ultrasonography, Doppler; D014469:Umbilical Arteries / Q000000981:diagnostic imaging / Q000502:physiology; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000502:physiology