Safety of conservative management of ovarian masses during pregnancy.
OBJECTIVE
To determine the clinical outcomes and risk factors for persistence of ovarian cysts in pregnant women. With the increased use of ultrasound in pregnancy, the identification of incidental ovarian masses is becoming more common.


METHODS
An observational study of women with ovarian masses identified before 24 weeks of pregnancy was performed. Only women who underwent follow-up imaging or surgery were included. Factors associated with persistence and outcomes of women who underwent surgery were analyzed.


RESULTS
Of the 803 women with available follow-up, the cysts resolved in 707 (88.1%) patients. Fifty (6.2%) women underwent surgical intervention. Women with persistent cysts were younger, more often Hispanic, detected at a later gestational age, had larger cysts, and more often had complex or solid components (p < 0.05 for all). Overall, 1 (0.1%) malignancy was diagnosed (a patient with a B-cell lymphoma), while 3 (0.4%) women had borderline epithelial ovarian tumors.


CONCLUSIONS
Ovarian masses identified during pregnancy have a low risk of malignancy. The majority of women can be serially monitored without intervention.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue, 8th Floor, New York, NY 10032, USA.
Paula C
PC
Brady
Lynn L
LL
Simpson
Sharyn N
SN
Lewin
Dorothy
D
Smok
Jodi P
JP
Lerner
Mary E
ME
D'Alton
Thomas J
TJ
Herzog
Jason D
JD
Wright
D005260:Female; D005865:Gestational Age; D006630:Hispanic or Latino; D006801:Humans; D010048:Ovarian Cysts / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D010051:Ovarian Neoplasms / Q000601:surgery / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery / Q000628:therapy*; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging / Q000628:therapy; D011256:Pregnancy Outcome; D016216:Ultrasonography, Prenatal