title: An 11-year experience with ovarian surgery during pregnancy.
abstract: BACKGROUND
  The management of ovarian tumors during pregnancy can be challenging because of the risk of fetal wastage and the possibility of surgery-related complications, or a delayed diagnosis of a possibly lethal disease or malignancy. The aim of this study was to study the characteristics and outcomes of pregnant women undergoing surgical intervention for ovarian tumors during pregnancy.
  
  
  METHODS
  We reviewed the data of 102 pregnant women who underwent ovarian surgery between 2000 and 2010 at Taipei Veterans General Hospital, Taiwan. Data subject to analysis included gestational age at the time of surgery, complications, surgical and pathological findings, and the outcome of pregnancy.
  
  
  RESULTS
  Fifty-two women who underwent surgery were excluded, whether by cesarean section, during the postpartum period or during simultaneous abortion surgery. Ultimately, the data of 50 patients were analyzed. Almost all patients (n = 46, 92%) were asymptomatic and underwent elective surgery. Frequently, this surgery was done in the second trimester (n = 35, 70%). We determined that teratoma (26%), mucinous cystadenomas (20%), and endometriomas (16%) were the three most common pathological findings. Nonspecific ovarian tumors were common (28%), including seven corpus luteum cysts, six simple cysts, and one paratubal cyst. Two women were diagnosed with malignant ovarian tumors, but both were metastatic and the primary site was the colon. Ten women underwent laparoscopic surgery. General anesthesia was used in four patients, and all underwent emergency exploratory laparotomy. There was no surgery-related complication or instance of preterm labor.
  
  
  CONCLUSIONS
  In our study cohort, surgical intervention during pregnancy was safe, since neither surgical approach, such as exploratory laparotomy or laparoscopic surgery, nor anesthesia methods, for example general anesthesia or spinal anesthesia showed negative impact on the pregnancy outcomes. Reported cases of malignant ovarian tumor are still rare, thus, the possibility of metastatic tumor should be considered first.
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Fan-Hlan
authors.initials: FH
authors.lastname: Koo
authors.forename: Kuan-Chin
authors.initials: KC
authors.lastname: Wang
authors.forename: Chih-Yao
authors.initials: CY
authors.lastname: Chen
authors.forename: Wen-Hsun
authors.initials: WH
authors.lastname: Chang
authors.forename: Chang-Ching
authors.initials: CC
authors.lastname: Yeh
authors.forename: Ming-Jie
authors.initials: MJ
authors.lastname: Yang
authors.forename: Ming-Shyen
authors.initials: MS
authors.lastname: Yen
authors.forename: Peng-Hui
authors.initials: PH
authors.lastname: Wang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D010053:Ovary / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies
keywords: laparoscopy; laparotomy; ovarian tumor; pregnancy