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Ovarian tumors associated with pregnancy: a 20-year experience in a teaching hospital

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

Pregnancy associated with ovarian tumors was reviewed over a 20-year period to determine the maternal and fetal outcome in patients undergoing surgery during pregnancy.

Method

A retrospective study of 94 cases of ovarian tumors treated surgically during pregnancy was investigated for incidence, clinico-pathological features and outcome in a teaching hospital between June 1987 and May 2007.

Results

The overall incidence of ovarian tumor in pregnant women was 1 in 505 (0.2%) deliveries. Diagnosis of 69.2% tumors resulted in the first and second trimesters of pregnancy. Twenty-two (23.4%) patients presented as an emergency at different periods of gestation and 16 (17.1%) tumors were incidentally discovered at cesarean section which underlines the significance of examining the ovaries routinely at cesarean section. Benign teratoma (39.4%) and serous cystadenoma (24.5%) were the most common types of ovarian tumors found in the study. The incidence of malignant tumors was 5.3%. Tumors with low malignant potential comprised 40% of malignancy. The miscarriage rate after surgery was 44.4% in the first trimester compared with 16.6% in the second trimester. The preterm birth rate was 4.3% in the series.

Conclusion

The value of clinical and ultrasound examinations in early pregnancy as a diagnostic aid is highlighted. Whenever an ovarian tumor is detected in pregnancy, malignancy should always be suspected. Treatment of an ovarian tumor in pregnancy should be tailored according to the age, parity, clinical presentation, gestational age and histopathology of the tumor. Removal of persisting or enlarging ovarian masses as soon as possible is important to obtain a final histologic diagnosis and rule out malignancy. Early diagnosis and appropriate treatment of malignant tumors offers the best prognosis for the patient.

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References

  1. Balci O, Gezginc K, Karatayli R, Acar A, Celik C, Colakoglu MC (2008) Management and outcomes of adnexal masses during pregnancy: a 6-year experience. J Obstet Gynaecol Res 34:524–528

    Article  PubMed  Google Scholar 

  2. Whitecar P, Turner S, Higby K (1999) Adnexal masses in pregnancy: a review of 130 cases undergoing surgical management. Am J Obstet Gynecol 181:19–24

    Article  CAS  PubMed  Google Scholar 

  3. Bernhard LM, Kiebba PK, Gray DL, Mutch DG (1999) Predictors of persistence of adnexal masses in pregnancy. Obstet Gynecol 93:585–589

    Article  CAS  PubMed  Google Scholar 

  4. Zanetta G, Mariani E, Lissoni A (2002) A prospective study of the role of ultrasound in the management of adnexal masses in pregnancy. BJOG 110:578–583

    Google Scholar 

  5. Hess LW, Peaceman A, O’Brien WF, Winkel CA, Cruikshank DP, Morrison JC (1988) Adnexal mass occurring with intrauterine pregnancy: report of fifty-four patients requiring laparotomy for definitive management. Am J Obstet Gynecol 158:1029–1034

    CAS  PubMed  Google Scholar 

  6. Grimes WH, Bartholomew RA, Colvin ED, Fish JJ, Lester WM (1954) Ovarian cysts complicating pregnancy. Am J Obstet Gynecol 68:549–605

    Google Scholar 

  7. Creasman WT, Rutledge F, Smith JP (1971) Carcinoma of the ovary associated with pregnancy. Obstet Gynecol 38:111–116

    CAS  PubMed  Google Scholar 

  8. Sherard GB III, Hodson CA, Williams HJ, Semer DA, Hadi HA, Tait DL, Greenville NC (2003) Adnexal masses and pregnancy: a 12-year experience. Am J Obstet Gynecol 189:358–363

    Article  PubMed  Google Scholar 

  9. Nelson MJ, Calvalieri R, Banders RC (1986) Cysts in pregnancy discovered by sonography. J Clin Ultrasound 14:509–512

    Article  CAS  PubMed  Google Scholar 

  10. Ueda M, Ueki M (1996) Ovarian tumors associated with pregnancy. Int J Obstet Gynaecol 55:59–65

    Article  CAS  Google Scholar 

  11. Beischer NA, Buttery BW, Fortune DW, Macafee CAJ (1971) Growth and malignancy of ovarian tumors in pregnancy. Aust NZ J Obstet Gynecol 11:208–211

    Article  CAS  Google Scholar 

  12. Di Saia PJ, Creasman WT (1997) Cancer in pregnancy. In: Di Saia PJ, Creasman WT (eds) Clinical gynecologic oncology, 5th edn. Mosby, St Louis, MO, pp 444–482

    Google Scholar 

  13. Curtis M, Hopkins MP, Zarlingo T, Martino C, Graciansky-Lengyl M, Jenison EL (1993) Magnetic resonance imaging to avoid laparotomy in pregnancy. Obstet Gynecol 82:833–836

    CAS  PubMed  Google Scholar 

  14. Struyk APHB, Treffers PE (1984) Ovarian tumors in pregnancy. Acta Obstet Gynecol Scand 63:421–424

    Article  CAS  PubMed  Google Scholar 

  15. Buttery BW, Beischer NA, Fortune DW, Macafee CAJ (1973) Ovarian tumors in pregnancy. Med J Aust 1:345–349

    CAS  PubMed  Google Scholar 

  16. Novak ER, Lambrou CD, Woodruff JD (1975) Ovarian tumors in pregnancy: an ovarian tumor registry review. Obstet Gynecol 46:401–406

    CAS  PubMed  Google Scholar 

  17. Kobayashi F, Sagawa N, Nakamura K, Nonogaki M, Ban C, Fujii S, Mori T (1989) Mechanism and clinical significance of elevated CA 125 levels in the sera of pregnant women. Am J Obstet Gynecol 160:563–566

    CAS  PubMed  Google Scholar 

  18. Spitzer M, Kaushal N, Benjamin F (1998) Maternal CA-125 levels in pregnancy and the puerperium. J Reprod Med 43:387–392

    CAS  PubMed  Google Scholar 

  19. Luesley DM, Weaver JB, Rushton DI (1984) A retrospective study of ovarian cysts in pregnancy. J Obstet Gynaecol 4:161–165

    Article  Google Scholar 

  20. Usui R, Minakami H, Kosuge S (2000) A retrospective survey of clinical, pathologic, and prognostic features of adnexal masses operated on during pregnancy. J Obstet Gynaecol Res 26(2):89–93

    Article  CAS  PubMed  Google Scholar 

  21. Rahman MS, Al-Sibai MH, Rahman J, Al-Suleiman SA, El-Yahia AR, Al-Mulhim AA, Al-Jama F (2002) Ovarian carcinoma associated with pregnancy. A review of 9 cases. Acta Obstet Gynecol Scand 81:260–264

    PubMed  Google Scholar 

  22. Agarwal N, Parul, Kriplani A, Bhatia N, Gupta A (2003) Management and outcome of pregnancies complicated with adnexal masses. Arch Gynecol Obstet 267:152–248

    Article  Google Scholar 

  23. Schmeler KM, Mayo-Smith WW, Peipert JF, Weitzen S, Manuel MD, Gordinier ME (2005) Adnexal masses in pregnancy: surgery compared with observation. Obstet Gynecol 105:1098–1103

    PubMed  Google Scholar 

  24. Leiserowitz GS, Xing G, Cress R, Brahmbhatt B, Dalrymple JL, Smith LH (2006) Adnexal masses in pregnancy: how often are they malignant? Gynecol Oncol 101:315–321

    Article  PubMed  Google Scholar 

  25. Chung A, Birnbaum SJ (1973) Ovarian cancer associated with pregnancy. Obstet Gynecol 41:211–214

    CAS  PubMed  Google Scholar 

  26. Reedy MB, Kallen B, Kuehl TJ (1997) Laparoscopy during pregnancy: a study of five fetal outcome parameters with use of the Swedish health registry. Am J Obstet Gynecol 177:673–679

    Article  CAS  PubMed  Google Scholar 

  27. Soriano D, Yefet Y, Seideman D, Goldenberg M, Mashiach S, Oelsner G (1999) Laparoscopy versus laparotomy in the management of adnexal masses during pregnancy. Fertil Steril 71:955–960

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, College of Medicine, King Faisal University, Dammam, Saudi Arabia

    Turki Gasim, Sana A. Al Dakhiel, Ahlam A. Al Ghamdi, Mariam Al Ali, Fathia Al Jama, Jessica Rahman, Suleiman A. Al Suleiman & Mohammad S. Rahman

  2. King Fahad Hospital, P.O. Box 40243, Al Khobar, 31952, Saudi Arabia

    Jessica Rahman

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  1. Turki Gasim
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  2. Sana A. Al Dakhiel
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  3. Ahlam A. Al Ghamdi
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  4. Mariam Al Ali
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  5. Fathia Al Jama
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  6. Jessica Rahman
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  7. Suleiman A. Al Suleiman
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  8. Mohammad S. Rahman
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Correspondence to Jessica Rahman.

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Gasim, T., Al Dakhiel, S.A., Al Ghamdi, A.A. et al. Ovarian tumors associated with pregnancy: a 20-year experience in a teaching hospital. Arch Gynecol Obstet 282, 529–533 (2010). https://doi.org/10.1007/s00404-009-1346-z

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  • DOI: https://doi.org/10.1007/s00404-009-1346-z

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