Author/Editor		Ribič-Pucelj, Martina; Kobal, Borut; Peternelj-Marinšek, Suzana
Title		Surgical treatment of adnexal masses in pregnancy: indications, surgical approach and pregnancy outcome
Type		članek
Source		J Reprod Med
Vol. and No.		Letnik 52, št. 4
Publication year		2007
Volume		str. 273-9
Language		eng
Abstract		Objective: To analyze the indications, surgical approach and pregnancy outcome in women undergoing surgical treatment of adnexal masses in pregnancy. Study design: In this retrospective study, 51 wom en were enrolled. Preoperative sonographic appearance, the size of the tumor, patient's age, gestational age at the time of surgery and pregnancy outcome following a laparoscopic and/or laparotomy approach were evaluated. The data were obtained from the National Perinatal Informational System, National Cancer Registry, inpatient records, operative reports and pathology records, and responses to a questionnaire on pregnancy outcome mailed to all the patients. Results: Of the 51 pregnant women with adnexal masses, 27 were treated laparoscopicaly and 24 through laparotomy. Acute symptoms were the indication in 14 (27.4%) and tumor > 5 cm or sonographic appearance in 37 (72.6%). There were 44 (86.4%) benign and 7 (13.6%) malignant masses (4 borderline and 3 cancers). There were no differences to pregnancy outcome between emergency and planned surgery or between laparoscopy and laparotomy. Conclusion: Surgical treatment of persistent adnexal masses in pregnancy, particularly those with a sonographic appearance of a complex tumor, is justified be cause of the high risk of torsion, rupture and malig nancy. Immediate treatment pregnancy outcome of symptomatic masses permits conservative, fertilitypreserving surgery and has no adverse effect on pregnancy outcome. Laparoscopic surgery and surgery in the first trimester do not impair pregnancy outcome.
Descriptors		PREGNANCY COMPLICATIONS, NEOPLASTIC ADNEXAL DISEASES TREATMENT OUTCOME PREGNANCY