Adnexal Masses in Pregnancy

2016 ◽  
Vol 10 (1) ◽  
pp. 78-82
Author(s):  
Harris Sara ◽  
Ausbeck Elizabeth ◽  
Goh William
Keyword(s):  
Obstet Gynecol ◽  
Adnexal Mass ◽  
Asymptomatic Patient ◽  
Expectant Management ◽  
First Trimester ◽  
Management Options ◽  
Adnexal Masses ◽  
Review Management ◽  
Laparoscopic Removal ◽  
In Pregnancy

ABSTRACT With the increased use of ultrasound in the first trimester, up to 4.5% of all pregnancies are diagnosed with an adnexal mass. The management of asymptomatic adnexal masses in pregnancy continues to be controversial. Potential complications include torsion and malignancy. This review will highlight the utility of ultrasound in generating a differential diagnosis for an adnexal mass based on their ultrasound characteristics. It will also review management options for the asymptomatic patient including expectant management and laparoscopic removal. How to cite this article Harris S, Ausbeck E, Goh W. Adnexal Masses in Pregnancy. Donald School J Ultrasound Obstet Gynecol 2016;10(1):78-82.

scholarly journals Adnexal Masses in Pregnancy: Diagnosis and Management

2007 ◽  
Vol 1 (4) ◽  
pp. 66-74 ◽  
Author(s):  
George M Graham
Keyword(s):  
Surgical Intervention ◽  
Adnexal Mass ◽  
Ultrasound Images ◽  
List Type ◽  
Management Options ◽  
Safe Alternative ◽  
Adnexal Masses ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
In Pregnancy

Abstract The widespread use of ultrasound in obstetrics has led to an increase in the diagnosis of asymptomatic adnexal masses in pregnancy. Ultrasound is an accurate and safe method for diagnosing the etiology of an adnexal mass and distinguishing benign from malignant pathology. The management of an adnexal mass in pregnancy is controversial. Historically, it was recommended that any adnexal mass be removed electively in the second trimester to exclude malignancy and prevent complications such as torsion, rupture, and obstruction of labor. More recent recommendations have limited surgical intervention in pregnancy to symptomatic adnexal masses and those that are highly suggestive of malignancy. Surgery in pregnancy is associated with an increased risk of adverse pregnancy outcomes. However, laparoscopy appears to be a safe alternative to laparotomy for benign masses when performed by experienced surgeons. Learning objectives To list the differential diagnoses of adnexal masses in pregnancy To interpret ultrasound images of adnexal masses and distinguish benign from malignant masses To describe the management options for adnexal masses in pregnancy, including the indications and options for surgical intervention.

Adnexal mass in pregnancy

2021 ◽  
Vol 10 (3) ◽  
pp. 1154
Author(s):  
Marilia Lima Freixo ◽  
Elisa Soares ◽  
Maria Liz Coelho ◽  
Fernanda Costa ◽  
Ana Rita Pinto
Keyword(s):  
Best Management Practices ◽  
Management Practices ◽  
Total Abdominal Hysterectomy ◽  
First Trimester ◽  
Abdominal Hysterectomy ◽  
Adnexal Masses ◽  
Best Management ◽  
Increased Risk ◽  
The Right ◽  
In Pregnancy

Adnexal masses in pregnancy are a rare finding. The majority of these masses are discovered incidentally during routine follow-up. The differential diagnosis of adnexal masses discovered during pregnancy is broad and the management of such lesions has been a subject of debate for years with no consensus regarding the best management plan. We report a case of a 38 year-old pregnant woman who was diagnosed at the time of the first trimester ultrasound with a multilocular solid arising form the right ovary. A laparoscopy followed by left oophorectomy was performed at 22 weeks and the definitive histology revealed a borderline ovarian cyst/proliferative mucinous atypical cyst. The patient delivered via vaginal at 38 weeks of gestation. This case was discussed and a secondary staging surgery (peritoneal washing, total abdominal hysterectomy, salpingo-oophorectomy, omentectomy, appendectomy, and peritoneal biopsies) was performed with no evidence of disease found. The surgical approach is controversial due to the increased risk of complications. In the absence of large prospective randomized trials it is difficult to know which are the best management practices and especially to determine the right moment during pregnancy to perform surgery in these patients. 

Adnexal Masses in Pregnancy: A Review

2018 ◽  
Vol 15 (1) ◽  
pp. 57-63
Author(s):  
Megan Pagan ◽  
Heather Jinks ◽  
Karen Wilson
Keyword(s):  
Gestational Age ◽  
Adnexal Mass ◽  
Clinical Course ◽  
Obstetric Ultrasound ◽  
Adnexal Masses ◽  
In Pregnancy

Diagnosis of adnexal masses in pregnancy has been increasing due to the routine use of obstetric ultrasound examinations. The clinical course varies widely based on the symptomatology, gestational age and ultrasound characteristics of the adnexal mass. Most adnexal masses identified in pregnancy are benign and resolve spontaneously. Complications, although relatively rare, can occur and include torsion, rupture and malignancy. This review will discuss the epidemiology, diagnosis, evaluation and management of adnexal masses during pregnancy.

scholarly journals Retroperitoneal schwannoma mimicking an adnexal mass in pregnancy

2019 ◽  
Vol 12 (8) ◽  
pp. e229438
Author(s):  
Rebecca Allen ◽  
Lorin Lakasing
Keyword(s):  
Adnexal Mass ◽  
Incidental Finding ◽  
Elective Caesarean Section ◽  
First Trimester ◽  
Complex Nature ◽  
Pelvic Ultrasound ◽  
Her Family ◽  
Retroperitoneal Schwannoma ◽  
First Trimester Scan ◽  
In Pregnancy

A 36-year-old pregnant woman attended her first trimester scan and there was an incidental finding of a right-sided complex cystic adenexal mass. Further investigations including repeat pelvic ultrasound scans and MRI were performed due to its complex nature but were inconclusive. Multidisciplinary team review of images found the mass to be retroperitioneal, neurogenic in origin and involving the L5 vertebrae. The pregnancy continued to term and the baby was delivered at 39 weeks gestation by elective caesarean section due to the mass being likely to obstruct progress in labour. Postnatal biopsy confirmed a schwannoma. Plans were made for resection however as the woman was asymptomatic she declined surgery in favour of completing her family. She conceived again 2 years later and a second pregnancy was managed in the same way. The size of the schwannoma remained stable throughout this period.

scholarly journals Pregnancy with adnexal masses: an institutional experience and review of the literature

2021 ◽  
Vol 10 (3) ◽  
pp. 1148
Author(s):  
Anupama Bahadur ◽  
Modalavalasa Swetha Sri ◽  
Rajlaxmi Mundhra ◽  
Latika Chawla ◽  
Megha Ajmani ◽  
...  
Keyword(s):  
Adnexal Mass ◽  
Cystic Teratoma ◽  
First Trimester ◽  
Third Trimester ◽  
Adnexal Masses ◽  
Institutional Experience ◽  
First Trimester Of Pregnancy ◽  
The Mean ◽  
Nicu Admission

Adnexal masses in pregnancy are not uncommon. We prospectively analysed all cases with adnexal masses detected during pregnancy presented to our antenatal outpatient department from January 2019 to August 2020. Herein we report six such cases with their pregnancy outcome. Among the 6 cases, 3 were diagnosed during first trimester of pregnancy, 2 in third trimester and 1 was found incidentally during caesarean section. The mean age of the cases was 25.33+2.33 years. Two cases underwent oophorectomy and rest had ovarian cystectomy. In terms of histopathological findings, one was endometriotic cyst, two were borderline tumors (mucinous and serous variety) and three were mature cystic teratomas. There was no perinatal mortality, but 2 babies required NICU admission for observation. Mature cystic teratoma was the most common adnexal mass detected in our series. Timing of surgery depends on urgency of situation. Asymptomatic/small/unilocular cyst with low suspicion should be kept under observation and follow up throughout pregnancy.

scholarly journals Placental Volume Measurement in Clinical Practice

2015 ◽  
Vol 9 (4) ◽  
pp. 408-412
Author(s):  
Junichi Hasegawa ◽  
Tatsuya Arakaki ◽  
Masamitsu Nakamura ◽  
Hiroko Takita ◽  
Akihiko Sekizawa
Keyword(s):  
Clinical Practice ◽  
Obstet Gynecol ◽  
Three Dimensional ◽  
First Trimester ◽  
Volume Measurement ◽  
Adverse Outcomes ◽  
Second Trimester ◽  
Sonographic Evaluation ◽  
Placental Volume ◽  
In Pregnancy

ABSTRACT Measurement of the placental volume during pregnancy can occasionally predict adverse outcomes, including ischemic and restricted conditions in the fetus and placenta later in pregnancy. Three-dimensional (3D) sonographic evaluation of the placental volume during the first trimester is a simple and rapid procedure that is commonly applied, but its use during the second trimester seems to be limited. The placental volume can be obtained within 5 minutes as part of daily clinical practice. Combining screening with the placental volume and other markers can increase the rate of detection of fetal and placental anomalies. In this article, we review the prediction of adverse maternal and fetal outcomes later in pregnancy using 3D sonographic measurement of the placental volume. How to cite this article Hasegawa J, Arakaki T, Nakamura M, Takita H, Sekizawa A. Placental Volume Measurement in Clinical Practice. Donald School J Ultrasound Obstet Gynecol 2015;9(4):408-412.

scholarly journals Burns in pregnancy: Five-year experience in a tertiary hospital in southeastern Nigeria

2021 ◽  
Vol 33 (3) ◽  
pp. 204-209
Author(s):  
Ugochukwu U. Nnadozie ◽  
Charles C Maduba ◽  
Gabriel M. Okorie ◽  
Lucky O. Lawani ◽  
Anikwe C Chidebe ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Burn Injury ◽  
First Trimester ◽  
Tertiary Hospital ◽  
University Teaching ◽  
Management Approach ◽  
Southeastern Nigeria ◽  
Spontaneous Vaginal Delivery ◽  
Review Management ◽  
In Pregnancy

BackgroundBurns in pregnancy is often associated with high maternal and fetal morbidity and mortality especially when the total burn surface area (TBSA) involved is high. This study aims to review management outcome of cases of burns in pregnancy at Alex Ekwueme Federal University Teaching Hospital Abakaliki (AE-FUTHA).MethodsA five year retrospective study of all pregnant women that presented at AE-FUTHA with burn injury between April 2014 and March 2019. Information was collected from the medical records using a proforma and analyzed with IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA) using descriptive statistics.ResultsA total of 222 cases of burns were managed but only 8 were pregnant, giving an incidence of 3.6%. The commonest causes were flame (62.5%), scald (25%) and friction (12.5%) occurring mostly during the harmattan season. The median age of participants was 25-34 years. The burns affected 12.5% of the patients in the first trimester and 62.5% and 25% in the 2nd and 3rd trimesters respectively. Most patients (62.5%) had superficial burns while 25% had other associated injuries in addition to burns. About 87.5% had term spontaneous vaginal delivery. There was no maternal death but, there was an early neonatal death.ConclusionThe good outcome observed in this study with a 100% survival, could be explained by inter-disciplinary management approach given, even as most cases were minor degrees of burns. Early involvement of obstetricians in all burns affecting pregnant women is advised especially in burn centres where obstetricians are hardly in the employ.

scholarly journals THE STUDY OF ADNEXAL MASSES IN PREGNANCY AT TERTIARY CENTER

2019 ◽  
pp. 1-4
Author(s):  
Richa A. Bharsakade ◽  
Maneesha R. Suryavanshi
Keyword(s):  
Adnexal Mass ◽  
Operative Management ◽  
Reproductive Age ◽  
Treatment Result ◽  
Ca 125 ◽  
Second Trimester ◽  
Adnexal Masses ◽  
Tertiary Center ◽  
Mucinous Cyst ◽  
In Pregnancy

BACKGROUND: Adnexal masses occur frequently during the reproductive age and during pregnancy. The management of adnexal masses during pregnancy presents a difficult clinical decision.The abdominal surgery during pregnancy is risky to the mother and the foetus. On contrary, conservative management may result in the spread of cancer or serious complication such as the torsion or rupture of ovarian cysts. METHODS:In observational study, 42 cases of adnexal masses in pregnancy were studied. These patients were evaluated with the respect to their size,tumor markers,histopathological report gestational age,and Perinatal outcome and treatment. RESULT: In present study 38 % patients were between the age of 25-30 years. It was seen commonly in multiparous women. It was commonly observed in second trimester,.40% cases were found to have adnexal mass between 6-10 cm. CA-125 was estimated for 30 patients in present study most commonly found adnexal mass was mucinous adenoma and dermoid cyst CONCLUSION:Majority of the adnexal masses are benign in nature.Dermoid cyst and mucinous cyst adenomas are the most common pathology foundin adnexal masses in pregnancy. Operative management for adnexal massis safe and hence most commonly performedin second trimester.

Peculiarities of ultrasound assesment of adnexal masses in pregnancy

GYNECOLOGY ◽  
2014 ◽  
Vol 16 (6) ◽  
pp. 37-43
Author(s):  
Yu.I. Lipatenkova ◽  
◽  
S.A. Martynov ◽  
L.V. Adamyan ◽  
A.Yu. Danilov ◽  
...  
Keyword(s):  
Adnexal Masses ◽  
In Pregnancy

Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

2020 ◽  
Vol 16 ◽  
Author(s):  
Divya Mirji ◽  
Shubha Rao ◽  
Akhila Vasudeva ◽  
Roopa P.S
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Management Strategy ◽  
Transvaginal Ultrasound ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Β Hcg ◽  
Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

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