title: Management of the adnexal mass in pregnancy.
abstract: OBJECTIVE
  With the increased use of ultrasonography in the first trimester, up to 1% of all pregnancies are diagnosed with an adnexal mass. Yet, the management of asymptomatic adnexal masses in pregnancy continues to be controversial as management guidelines are mainly based on case-control or observational studies. The purpose of this article was to review the recent literature and provide clinical guidance on patient management.
  
  
  RESULTS
  This review will highlight the increasing sensitivity of ultrasound imaging in diagnosing the rare malignant lesion, allowing for antenatal expectant management of benign asymptomatic adnexal masses until delivery or postpartum. The recent literature also highlights the well tolerated use of laparoscopy for the antenatal removal of suspicious or symptomatic masses and that expectant management of asymptomatic masses does not increase the risk of adverse pregnancy outcomes.
  
  
  CONCLUSIONS
  Most adnexal masses are benign and ultrasound characteristics can help guide the assessment of asymptomatic ovarian masses. When surgical management is chosen, laparoscopy can be safely performed in pregnancy. Ovarian torsion is a complication for persistent masses in pregnancy.
authors.affiliation: aHawaii Permanente Medical Group, Honolulu, Hawaii bUniversity of Wisconsin School of Medicine, Madison, Wisconsin cJohn A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA.
authors.forename: William
authors.initials: W
authors.lastname: Goh
authors.forename: Justin
authors.initials: J
authors.lastname: Bohrer
authors.forename: Ivica
authors.initials: I
authors.lastname: Zalud
mesh_terms: D000291:Adnexal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D018394:CA-125 Antigen / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D033162:Incidental Findings; D010048:Ovarian Cysts / Q000000981:diagnostic imaging*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011256:Pregnancy Outcome; D011264:Pregnancy Trimesters; D012421:Rupture; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen