title: Surgical management of adnexal masses in pregnancy.
abstract: OBJECTIVE
  Our objective was to review the surgical management, surgical outcomes, and obstetric outcomes of adnexal masses in pregnancy.
  
  
  METHODS
  A retrospective review was performed of pregnant women before 20 weeks of gestation who underwent laparoscopy or laparotomy for management of an adnexal mass during the period of January 2005 to June 2012 at a university-affiliated hospital.
  
  
  RESULTS
  Thirty-five pregnant women underwent surgical removal of adnexal masses during the 7.5-year study period: 21 (60.0%) underwent laparoscopic surgery, and 14 (40.0%) underwent laparotomy. The left upper quadrant entry technique was used in 20 women. Conversion to laparotomy was required in 2 women because of extensive pelvic adhesions. The mean gestational age at surgery was 15.2 ± 1.9 weeks. All women had undergone ovarian cystectomy. A malignant mass was found in 3 (8.6%) women. The laparoscopy group had a significantly less blood loss (67.4 ± 55.8 vs 153.6 ± 181.0 mL, P = .048) and shorter mean hospital stay (2.8 ± 1.0 vs 3.8 ± 1.1 days, P = .006) than the laparotomy group. One woman miscarried soon after surgery. There was no significant difference in obstetric outcomes between the laparoscopy and laparotomy groups.
  
  
  CONCLUSIONS
  Surgical management of adnexal masses during pregnancy appears to have favorable outcomes for the mother and the fetus.
authors.affiliation: Department of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong SAR. ngusiewf@hku.hk.
authors.forename: Siew-Fei
authors.initials: SF
authors.lastname: Ngu
authors.affiliation: Department of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR.
authors.forename: Vincent Y T
authors.initials: VY
authors.lastname: Cheung
authors.affiliation: Department of Obstetrics and Gynecology, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR.
authors.forename: Ting-Chung
authors.initials: TC
authors.lastname: Pun
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis / Q000601:surgery*; D000328:Adult; D003937:Diagnosis, Differential; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000601:surgery*; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome