title: Management of adnexal masses in pregnancy: our experience from a tertiary referral perinatal centre in South India.
abstract: OBJECTIVE
  Adnexal masses in pregnancy are often incidentally detected during sonography and most resolve spontaneously by early second trimester. This study aimed to look at the prevalence and management of adnexal masses in pregnancy at a tertiary care referral perinatal hospital.
  
  
  METHODS
  This is a retrospective study of all women with adnexal masses (excluding ectopic gestations and non-gynaecological lesions) identified pre-pregnancy or during pregnancy (antepartum/intrapartum) from January 2006 to August 2013 at the study institute.
  
  
  RESULTS
  The study identified 252 women (0.6, 95 %, CI: 0.5, 0.7) with adnexal masses and mean (SD range) age of 27.1 (4.21, 18-39) years. Majority (80 %) of the masses were diagnosed incidentally. 170 (67.5 %) women were offered conservative management and cysts resolved in half of them. 87 (34.5 %) women had adnexal surgery and 15.1 % were operated during the antepartum period because of persistent abdominal pain or suspicious sonographic findings. Three (1.2 %) malignancies and five (2.0 %) borderline ovarian tumours were diagnosed on histopathological examination. 16 (6.3 %) women were lost to follow-up antenatally. Pregnancy carried to term in 175 (69.4 %) women. Perinatal mortality rate was 31.1/1,000 total births (caused by prematurity). Complications encountered were torsion (7.1 %), malignancy (1.2 %), rupture (0.4 %) and infection (0.4 %).
  
  
  CONCLUSIONS
  Although conservative management was appropriate in the majority of cases, the study identifies the need to standardize diagnosis, investigations and management for a better evaluation of outcomes.
authors: Department of Gynaecology, Fernandez Hospital, Fernandez Hospital Unit 1, 4-1-1230, Bogulkunta, Hyderabad, Andhra Pradesh, 500001, India.
authors: Kameswari
authors: K
authors: Surampudi
authors: Praveen Kumar
authors: PK
authors: Nirmalan
authors: Sirisha Rao
authors: SR
authors: Gundabattula
authors: Jogitha Bharathi
authors: JB
authors: Chandran
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D059012:Lost to Follow-Up; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D011262:Pregnancy Trimester, Second; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult