A Clinical Study on Adnexal Tumors in Pregnancy

Park, Jin Wook; Koo, Tae Bon; Park, Il Soo

Abstract

OBJECTIVE
To evaluate the clinicopathologic features and clinical outcomes of adnexal tumors in pregnancy.
METHODS
After review of charts of 51 patients managed at Kyungpook National University Hospital from January 1996 to June 2002, data including clinical findings, treatments and outcomes were analyzed.
RESULTS
The mean age of pregnant women with adnexal tumors was 28.5 years old and the adnexal tumors were more common in nulliparous pregnant women (74.5%) than parous those. There were asymptomatic or no signs in 40 cases (78.4%), lower abdominal pain in 9 cases (17.6%), vaginal bleeding in 1 case (2.0%) and palpable mass by patient herself in 1 case (2.0%). The surgical treatments were performed at first trimester in 9 cases (19.1%), second trimester in 31 cases (66.0%) and third trimester in 7 cases (14.9%). Postoperative histopathologic diagnoses of adnexal tumors were 22 cases (43.1%) of benign cystic teratoma, 7 cases (13.8%) of functional cyst, 6 cases (11.8%) of serous cystadenoma, 4 cases (7.8%) of mucinous cystadenoma, 4 cases (7.8%) of endometrioma, 3 cases (5.9%) of parovarian cyst and 4 cases (7.8%) of malignancy including 2 cases of mucinous cystadenocarcinoma and 2 cases of mucinous tumor, borderline. The complication resulting from adnexal tumors was torsion of 6 cases (11.8%). The outcome of pregnancy was available in 30 cases, term delivery in 25 cases (83.3%), preterm delivery in 3 cases (10%) and spontaneous abortion in 2 cases (6.7%).
CONCLUSION
Although the incidence of adnexal tumors with pregnancy is variable according to the reports, the detection rate is more and more increasing due to a widespread application of ultrasound. Thus, obstetricians must always consider adnexal tumors combined with pregnancy and try to minimize the complications of surgery during pregnancy to prevent adverse fetal outcome and maternal morbidity.